Granulomatous Thyroiditis Post Tuberculosis Infection Mimicking a Neoplasm

Granulomatous thyroiditis is a diffuse inflammation of the thyroid gland that has a wide range of etiologies like viral, bacterial, and autoimmune conditions. The most common type is subacute granulomatous thyroiditis due to viral infection, seen in the middle-aged group and affects women. A 65-year-old woman, presented with complaints of anterior neck swelling for three months. Due to lack of pain, her age, a positive family history, and atypical cells on workup, she was posted for total thyroidectomy and the specimen was sent for histopathological examination (HPE). The report showed nodular goiter with focal granulomas, and a diagnosis of granulomatous thyroiditis was made. Post-operative CT chest showed scarring of the lung, so the etiology was narrowed down to tuberculosis. Granulomatous thyroiditis mimicking a neoplasm is uncommon in the elderly. A detailed workup must be done to identify the etiology and treat any underlying infection.