Thyroid & parathyroid



Topic Completed: 1 March 2009

Minor changes: 16 September 2020

Copyright: 2003-2021,, Inc.

PubMed search: Hashimoto's thyroiditis WITH "fibrosing"

Related topics: Hashimoto's thyroiditis

Shahid Islam, M.D., Ph.D.
Page views in 2020: 1,669
Page views in 2021 to date: 1,323
Cite this page: Islam S. Hashimoto-fibrous. website. Accessed November 27th, 2021.
Definition / general
  • 10 - 12% of all cases
  • Large symptomatic goiter, marked hypothyroidism
  • Fibrous atrophy variant:
    • Similar to fibrous variant but thyroid gland is much smaller (1 - 6 g)
    • Elderly patients with marked hypothyroidism and high titers of antithyroid antibodies
  • Hypothyroidism with increased TSH
  • Markedly elevated antithyroglobulin antibody
  • Surgery to relieve dysphagia or dyspnea
Gross description
  • Large goiter does not adhere to surrounding structures
  • May not be recognizable as thyroid tissue
Microscopic (histologic) description
  • Extensive dense (keloid-like) hyaline fibrosis within thyroid capsule
  • Often extensive squamous metaplasia
  • Marked follicular atrophy, although lobular architecture of gland is maintained
Microscopic (histologic) images

AFIP images

Metaplastic squamous follicles

Dilated lumen of metaplastic follicle

Various images

Differential diagnosis
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