診断まで長期間を要した甲状腺結核の1例

Delayed diagnosis of thyroid tuberculosis

Ⅰ　はじめに

　本症例はかつて当院の前身である東京都立府中病院から『皮膚瘻孔を生じた亜急性甲状腺炎（de Quervain）の1例』として本誌に報告した症例である^1）。その後の長期にわたる経過観察により頸部から結核菌が同定され，加療を行うと同時に，稀な甲状腺結核であったと判明したので，文献的考察を加えて報告する。

　Hemithyroidectomy was performed on a 60-year-old Japanese man. He was initially diagnosed as having subacute thyroiditis（de Quervain）according to the pathological findings of surgical specimen. After the surgery,however,he had been suffering from multiple cervical fistulas and intermittent purulent drainage for a long time. Nine years later,his cervical lymphadenitis revealed tuberculosis infection by bacteriological test,and the pathological finding of the swelling lymph node was as same as that of previous hemithyroidectomy. The discharge from the multiple fistulas and lymphadenitis responded well to the oral anti-tubercular agents,then the initial diagnosis was finally corrected as thyroid tuberculosis.