Abstract
We experienced a case of diffuse enlargement of the thyroid after fine-needle aspiration cytology of an adenomatous goiter. We followed its clinical course and some bibliographic considerations. The patient was a 38-year-old woman. She was diagnosed with a nodular goiter at another hospital, and was referred to our hospital after it increased in size. She had no particular history of internal medication. When fine-needle aspiration cytology was performed on the left lobe of the affected side using a 22G injection needle, she complained of feeling pressure and pain in the neck 2 or 3 minutes later. The right lobe of the unaffected side was observed to have swollen from 1 cm to 4 cm by echo, and internal blood flow was increased. Since there was no improvement after cooling the neck with an ice chip for 1 hour, a steroid was administered and the symptoms rapidly improved. When an echo was conducted after 9 days of decreasing steroid administration, the swelling had improved. We were able to follow-up with periodic echo images. Steroid treatment was conducted before and after surgery, and the patient was discharged after successful surgery without complications. It is conjectured that the diffuse swelling occurred because nerves in the thyroid were accidentally stimulated by the fine-needle aspiration cytology, causing vasodilation and release of vascular permeability factors.
