Riedel Struma Zurück
E06.5 Sonstige chronische Thyreoiditis
Thyreoiditis:
chronisch:
- fibrös
- o. n. A.
-eisenhart
-Riedel-Struma (invasiv-sklerosierende
Thyreoiditis)
Chronic invasive fibrous thyroiditis (Riedel's struma) is a very rare disease of unknown aetiology mainly affecting middle-aged or old female patients. An aggressive fibrosis partly or totally replaces normal thyroid gland tissue. The gland becomes stony hard, is not displaceable and, characteristically, the fibrous tissue penetrates the capsule and infiltrates into surrounding structures such as muscles, vessels, nerves and even the trachea. Riedel's struma is often associated with fibrotic processes in other parts of the body.
unbekannt
sehr seltene Erkrankung
Arch Ital Anat Istol Patol 1967;41(3):289-338
Anatomo-histological and pathogenetic contribution to the knowledge of chronic aspecific thyroiditis: Hashimoto's struma, De Quervain's thyropathy, Riedel's ligneous thyroiditis.
Article in Italian
Schlich G
PMID: 5633342, UI: 70266455
Schwaergerle SM, Baner TW, Esselstyn CB Jr. 1988
Riedel’s thyroiditis.
Am J Clin Pathol 90:715
A mixed population of B- and T-cells is present in the thyroid, suggesting an autoimmune etiology or association.
The occurrence of marked tissue eosinophilia and the extracellular deposition of eosinophil granule major basic protein suggests a role for eosinophils and their products in the development of fibrosis in Riedel’s thyroiditis
Evidence for autoimmune mechanisms in the evolution of invasive fibrous thyroiditis (Riedel's struma).
Clin Investig. 1994 Oct;72(10):788-93.
PMID: 7865983; UI: 95170239
are caused by the local pressure, and if there is enough pressure on both recurrent laryngeal nerves, there may be stridor.
Sometimes the disease is asymptomatic and discovered only incidentally.
Rarely, Riedel's thyroiditis may be associated with similar fibrosclerotic processes in other areas, including the
in varying combinations in the syndrome of multifocal fibrosclerositis.
Anamnesefragen
Körperliche Untersuchung
Tastbefund der SD
Labor
SD Laborwerte , T3,T4,TSH
SD Antikörper
Sonstige Verfahren
Differential Diagnostik
Literatur
AJNR Am J Neuroradiol 2000 Feb;21(2):320-1
Riedel's thyroiditis in multifocal fibrosclerosis: CT and MR imaging findings.
Ozgen A, Cila A
Department of Radiology, Hacettepe University, School of Medicine, Sihhiye, Ankara, Turkey.
Riedel's thyroiditis is a rare disorder of unknown etiology and may be seen isolated or as a part of multifocal fibrosclerosis. It is important to distinguish Riedel's thyroiditis from thyroid carcinoma. Reports about imaging features of Riedel's thyroiditis are limited in the radiologic literature. We describe herein CT and MR imaging features of Riedel's thyroiditis in a case of multifocal fibrosclerosis with previously unreported radiologic observations.
PMID: 10696016, UI: 20158563
J Comput Assist Tomogr 1993 Mar-Apr;17(2):324-5
Riedel thyroiditis: US, CT, and MR evaluation.
Perez Fontan FJ, Cordido Carballido F, Pombo Felipe F, Mosquera Oses J, Villalba Martin C
Department of Radiology, Hospital Juan Canalejo, La Coruna, Spain.
We report the ultrasound, CT, and MR findings in a patient with Riedel thyroiditis. The hypointensity of the lesion observed on T1- and T2-weighted sequences, especially when associated with infiltration of adjacent structures of the neck, can be suggestive of Riedel thyroiditis.
PMID: 8454764, UI: 93203478
Thomson JA, Jackson IM, Duguid WP. Related Articles
The effect of steroid therapy on Riedel's thyroiditis.
Scott Med J. 1968 Jan;13(1):13-6. No abstract available.
PMID: 5694137; UI: 68121723
Vaidya B, Harris PE, Barret P, Kendall-Taylor P, 1997.
Corticosteroid therapy in Riedel’s thyroiditis.
Postgrad Med 73:817-819.
The disease may remain stable over many years, or it may progress slowly and produce hypothyroidism
Yu YX.
Fourteen cases of Riedel's struma: review of the literature
Chung Hua Wai Ko Tsa Chih. 1993 Apr;31(4):226-8. Chinese.
PMID: 8275838; UI: 94102020
Cooper D. Related Articles
Case 15-1985.
N Engl J Med. 1985 Aug 29;313(9):583. No abstract available.
PMID: 4022095; UI: 85267963
Q J Med 1989 Aug;72(268):709-17
Invasive fibrous thyroiditis (Riedel's struma): a manifestation of multifocal fibrosclerosis? A case report with review of the literature.
de Lange WE, Freling NJ, Molenaar WM, Doorenbos H
Department of Internal Medicine, University Hospital, Groningen, The Netherlands.
A patient is described with Riedel's thyroiditis and invasive fibrous growth in parathyroid, lacrimal glands, and retroperitoneally. It is proposed that Riedel's thyroiditis is not a disease in its own right but a manifestation of a generalized disease of fibrous tissues.
Review
Review of reported cases
PMID: 2690181, UI: 90099757
Ann Endocrinol (Paris) 1979 Jan-Feb;40(1):65-6
A case of regressive Riedel's thyroiditis.
Article in French
Hartemann P, Leclere J, Mizrahi R, Zannetti A, Genton P, Parache RM
Riedel's struma is one among the locations of an invasive fibroinflammatory and sometimes multifocal process, of unknown etiology. This disease is extremely rare. The authors report a further case in a 41 year old man who had been developing a woody goiter for 3 months. Laboratory investigations showed normal inflammation tests, high rates of antithyroid antibodies and mild hypothyroidism. A surgical operation only consisted in a biopsy, which revealed typical histological features. The only treatment used was a suppletive therapy. During the evolution, antithyroid antibodies progressively decreased, hypothyroidism moderately increased and, chiefly, the goiter completely disappeared after 18 months. To our knowledge, regressive evolution was reported in very few cases after corticoid therapy, but never spontaneously.
PMID: 443740, UI: 79185979
Wien Klin Wochenschr 1988 Apr 1;100(7):210-5
Chronic invasive fibrous thyroiditis (Riedel struma). Case report with special reference to preoperative diagnosis.
Article in German
Beham A, Langsteger W, Schmid C, Lind P, Kronberger D
Institut fur Pathologische Anatomie, Universitat Graz.
Chronic invasive fibrous thyroiditis (Riedel's struma) is a very rare disease of unknown aetiology mainly affecting middle-aged or old female patients. An aggressive fibrosis partly or totally replaces normal thyroid gland tissue. The gland becomes stony hard, is not displaceable and, characteristically, the fibrous tissue penetrates the capsule and infiltrates into surrounding structures such as muscles, vessels, nerves and even the trachea. Riedel's struma is often associated with fibrotic processes in other parts of the body. The preoperative differential diagnosis includes malignant tumours and fibrosing stages of Hashimoto's disease, as well as subacute thyroiditis de Quervain. This paper reports the case of a 60-year-old woman suffering from Riedel's struma and discusses differential diagnostic aspects with regard to preoperative investigation and pathohistology.
PMID: 3287769, UI: 88237411
J Intern Med 1994 Mar;235(3):271-4
Riedel's thyroiditis: an autoimmune or primary fibrotic disease?
Zimmermann-Belsing T, Feldt-Rasmussen U
Department of Medicine P, University Hospital, Rigshospitalet, Denmark.
Riedel's thyroiditis is a rare condition with an unknown aetiology. The condition was discovered by Riedel in 1883. In 1904, Hashimoto described another condition of invasive fibrous thyroiditis. Since then it has been discussed whether Hashimoto's thyroiditis and Riedel's thyroiditis are one disease in different states or whether they are two different diseases. Hashimoto's thyroiditis is known to have an autoimmune aetiology and can be seen in conjunction with other autoimmune diseases such as pernicious anaemia. The co-existence of Riedel's thyroiditis and pernicious anaemia is reported for the first time in this case story. Our patient was initially treated with a high dose of steroids and today is well on low-dose steroids and without relapse. The co-existence mentioned, the good effect of steroid treatment, the frequent presence of thyroid autoantibodies and lymphoid infiltration of the thyroid gland resembling that of Hashimoto's thyroiditis might indicate an autoimmune aetiology. It may be that the action on fibroblasts of cytokines known to be released by infiltrating lymphocytes constitutes a possible fibrogenic mechanism, but the primary lesion is still unknown.
Comments:
Comment in: J Intern Med 1995 Jul;238(1):85-6
PMID: 8120524, UI: 94165651
Rev Mal Respir 1995;12(1):66-8 Related Articles, Books, LinkOut
Mediastinal fibrosis associated with Riedel's thyroiditis. Apropos of a case.
Article in French
Sembach N, Benhamou D, Girault C, Testard J, Ozenne G, Muir JF
Service de Pneumologie, CHU de Rouen, Bois-Guillaume.
The authors describe a case of mediastinal fibrosis in a 53 year old woman which presented with a superior venacaval syndrome ten years after the diagnosis of a Riedel's thyroiditis. The clinical and laboratory evidence did not reveal anything to suggest other fibrosing disorders (such as retroperitoneal fibrosis, extra-hepatic biliary fibrosis or orbital fibrosis) which could be associated either simultaneously or successively with this multi-focal fibrosis. The physiology of this disorder currently remains imprecise. A current hypothesis is that there is an immunological reaction in the periarterial area leading to lipid components make atheromatous plaques. The therapeutic means are limited and depend on the localisation of the fibrous tissue and of their functional repercussions. Currently, the benefit of corticosteroids on the mediastinal fibrotic lesions has not been demonstrated.
PMID: 7899673, UI: 95207571
Ann Otolaryngol Chir Cervicofac 1983;100(7):527-31
Riedel's thyroiditis. Apropos of a case with acute massive fibrous development.
Article in French
Contencin P, Senechal B, Senechal G
Before a brief historical review of the disease, including its classical diagnostic criteria, the authors present a true case of Riedel's thyroiditis. After an initial operation involving virtually complete excision of the affected lobe, the course was particularly rapid with very extensive cervical fibrosis which resulted in death from tracheal and oesophageal complications. Such rapidly progressive secondary fibrosis has not been described before and did not have the histological characteristics of a recurrence. The authors liken it to phenomena of fibrosis frequently described as being associated with Riedel's disease (retroperitoneal fibrosis, fibrosing cholangitis, orbital pseudotumour, etc.). Bearing in mind that glucocorticosteroids have a beneficial action on such sites, the authors wonder whether routine preoperative corticosteroid therapy might not have avoided such an early fatal outcome in this patient.
PMID: 6638777, UI: 84050671
Ir J Med Sci 1994 Apr;163(4):176-7 Related Articles, Books, LinkOut
Riedel's thyroiditis--case report and literature review.
Brady OH, Hehir DJ, Heffernan SJ
Mater Misericordiae Hospital, Dublin.
A fifty two year old female underwent attempted thyroidectomy for a progressively enlarging cervical swelling. At operation the thyroid gland was extensively fibrosed and not resectable, frozen section showed fibrous replacement. The patient was given a short course of postoperative corticosteroid therapy and was maintained on thyroid replacement therapy. Thirty months later the patient remains asymptomatic.
Publication Types:
Review
Review, tutorial
PMID: 8200781, UI: 94259578
Folia Endocrinol 1972 Dec;25(6):495-501
Riedel's thyroiditis associated with hypoparathyroidism.
Article in Italian
Austoni M, Conte N, Zaccaria M, Bottazzo GF
PMID: 4679301, UI: 73258912
Es gibt keine echten Experten da die Krankheit zu selten ist
Alle Schilddrüsen Experten sollten von der Krankheit gehört haben.
keine bekannt
Riedel BMCL 1896
Die chronische, zur Bildung eisenharter Tumoren führende Entzündung der Schilddrüse.
Verh Dtsch Ges Chir 25:101
Hines RC, Scheuermann HA, Royster HP, Rose E.
Invasive fibrous (Riedel's) thyroiditis with bilateral fibrous parotitis.
JAMA. 1970 Aug 3;213(5):869-71. No abstract available.
PMID: 5468639; UI: 70268929
Heufelder AE, Hay ID.
Evidence for autoimmune mechanisms in the evolution of invasive fibrous thyroiditis (Riedel's struma).
Clin Investig. 1994 Oct;72(10):788-93.
PMID: 7865983; UI: 95170239
Intenzo CM, Park CH, Kim SM, Capuzzi DM, Cohen SN, Green P.
Clinical, laboratory, and scintigraphic manifestations of subacute and chronic thyroiditis.
Clin Nucl Med. 1993 Apr;18(4):302-6.
PMID: 8386991; UI: 93245433
Yu YX.
Fourteen cases of Riedel's struma: review of the literature
Chung Hua Wai Ko Tsa Chih. 1993 Apr;31(4):226-8. Chinese.
PMID: 8275838; UI: 94102020
Chirurg 1991 Mar;62(3):211-3
Riedel's thyroiditis and idiopathic multifocal fibrosclerosis. A case report.
Article in German
Wich M, Steegmuller KW, Junginger T, Teifke A
Klinik und Poliklinik fur Allgemein-und Abdominalchirurgie, Johannes-Gutenberg-Universitat Mainz.
PMID: 2036898, UI: 91243522
Best TB, Munro RE, Burwell S, Volpe R.
Riedel's thyroiditis associated with Hashimoto's thyroiditis, hypoparathyroidism, and retroperitoneal fibrosis.
J Endocrinol Invest. 1991 Oct;14(9):767-72.
PMID: 1761813; UI: 92105637
Binter G, Lind P, Langsteger W, Klima G, Koltringer P, Beham A, Eber O.
Clinical significance of Tl-201/Tc-99m subtraction scintigraphy as a parameter for surgical indication of cold struma nodules.
Acta Med Austriaca. 1990;17(2-3):55-8. German.
PMID: 2220269; UI: 91021844
8: Fosse E, Fjeld NB, Arnkvaern R, Semb G, Sauer T.
Mediastinal fibrosis. A case report.
J Oslo City Hosp. 1989 Aug-Sep;39(8-9):103-6.
PMID: 2809854; UI: 90039740
de Lange WE, Freling NJ, Molenaar WM, Doorenbos H.
Invasive fibrous thyroiditis (Riedel's struma): a manifestation of multifocal fibrosclerosis? A case report with review of the literature.
Q J Med. 1989 Aug;72(268):709-17. Review.
PMID: 2690181; UI: 90099757
Beham A, Langsteger W, Schmid C, Lind P, Kronberger D.
Chronic invasive fibrous thyroiditis (Riedel struma). Case report with special reference to preoperative diagnosis.
Wien Klin Wochenschr. 1988 Apr 1;100(7):210-5. German.
PMID: 3287769; UI: 88237411
Westhoff M.
Riedel's struma and fibrous mediastinitis. Positive therapeutic responsiveness to corticoids.
Dtsch Med Wochenschr. 1988 Mar 4;113(9):337-41. German.
PMID: 3345695; UI: 88151679
Westhoff M.
Riedel's struma and fibrous mediastinitis. Their relation to multifocal fibrosis.
Dtsch Med Wochenschr. 1988 Mar 4;113(9):348-51. Review. German. No abstract available.
PMID: 3278877; UI: 88151682
Kumar PV.
Riedel's struma in a child.
Indian J Pathol Microbiol. 1987 Jul;30(3):287-9. No abstract available.
PMID: 3449458; UI: 88212549
Hamburger JI.
The various presentations of thyroiditis. Diagnostic considerations.
Ann Intern Med. 1986 Feb;104(2):219-24. Review.
PMID: 3511814; UI: 86128603
Hay ID.
Thyroiditis: a clinical update.
Mayo Clin Proc. 1985 Dec;60(12):836-43. Review.
PMID: 3906289; UI: 86064239
16: Epishin AV.
[Cellular and humoral immunity indices in Hashimoto's thyroiditis, Riedel's Struma and nodular nontoxic goiter].
Vrach Delo. 1982 Jun;(6):19-21. Russian. No abstract available.
PMID: 6896779; UI: 82279291
17: Wilmshurst P, Melsom R, Gostelow B.
Orbital pseudotumour and lacrimal involvement developing in a patient with Riedel's struma receiving steroids.
Clin Endocrinol (Oxf). 1981 Jan;14(1):63-7.
PMID: 7226575; UI: 81186910
18: Esdaile J, Murray D, Hawkins D, MacKenzie R.
Idiopathic fibrosis of the lateral compartment of the neck.
Arch Intern Med. 1980 Oct;140(10):1386-7.
PMID: 7425775; UI: 81038299
19: Hartemann P, Leclere J, Mizrahi R, Zannetti A, Genton P, Parache RM.
A case of regressive Riedel's thyroiditis.
Ann Endocrinol (Paris). 1979 Jan-Feb;40(1):65-6. French.
PMID: 443740; UI: 79185979
Volpe R.
The pathology of thyroiditis.
Hum Pathol. 1978 Jul;9(4):429-38.
PMID: 581380; UI: 79047005
Chopra D, Wool MS, Crosson A, Sawin CT.
Riedel's struma associated with subacute thyroiditis, hypothyroidism, and hypoparathyroidism.
J Clin Endocrinol Metab. 1978 Jun;46(6):869-71.
PMID: 263470; UI: 84162517
Iida F, Miyakawa M.
Clinico-pathological study of chronic thyroiditis.
Nippon Naibunpi Gakkai Zasshi. 1976 Mar 20;52(3):173-82. Japanese.
PMID: 986957; UI: 77003811
Schneider RJ.
Orbital involvement in Riedel's struma.
Can J Ophthalmol. 1976 Jan;11(1):87-90.
PMID: 1247944; UI: 76115984
Redelbach J, Drews M.
Riedel's struma.
Pol Przegl Chir. 1973 Dec;45(12):1421-6. Polish. No abstract available.
PMID: 4767810; UI: 74068805
25: Rao CR, Ferguson GC, Kyle VN.
Retroperitoneal fibrosis associated with Riedel's struma.
Can Med Assoc J. 1973 Apr 21;108(8):1019-21. No abstract available.
PMID: 4699273; UI: 73163288
26: Kipenskii AA.
Riedel's struma in children.
Sov Med. 1971 Nov;34(11):145-6. Russian. No abstract available.
PMID: 5160628; UI: 72117315
27: Rzepecki A, Kossak J, Zwykielski G.
Results of surgical treatment of Riedel's struma.
Pol Przegl Chir. 1970 Jul;42(7):1041-2. Polish. No abstract available.
PMID: 5451480; UI: 70266153
28: Piroth M, Weis HJ.
Takayasu's arteritis and Riedel's struma.
Arch Klin Med. 1969;216(2):105-15. German. No abstract available.
PMID: 5797981; UI: 69250143
29: Jelinek R, Hraba M.
Riedel's struma.
Cesk Otolaryngol. 1968 Dec;17(6):337-40. Czech. No abstract available.
PMID: 5709805; UI: 69111330
30: Abulafia J, Sorondo LP, Schlossberg R.
[Subcutaneous idiopathic fribomatosis(fascitis type). Combined with idiopathic mediastinal firosis and Riedel's struma].
Arch Argent Dermatol. 1967 Mar;17(1):1-20. Spanish. No abstract available.
PMID: 5605157; UI: 69091930
31: Schlich G.
Anatomo-histological and pathogenetic contribution to the knowledge of chronic aspecific thyroiditis: Hashimoto's struma, De Quervain's thyropathy, Riedel's ligneous thyroiditis.
Arch Ital Anat Istol Patol. 1967;41(3):289-338. Italian. No abstract available.
PMID: 5633342; UI: 70266455
Raphael HA, Beahrs OH, Woolner B, Scholz DA.
Riedel's struma associated with fibrous mediastinitis: report of a case.
Mayo Clin Proc. 1966 Jun;41(6):375-82. No abstract available.
PMID: 5939403; UI: 66153399
Weber AL, Randolph G, Aksoy FG.
The thyroid and parathyroid glands. CT and MR imaging and correlation with pathology and clinical findings.
Radiol Clin North Am. 2000 Sep;38(5):1105-29.
PMID: 11054972; UI: 20508758
Natt N, Heufelder AE, Hay ID, Grant CS, Goellner JR.
Extracervical fibrosclerosis causing obstruction of a ventriculo-peritoneal shunt in a patient with hydrocephalus and invasive fibrous thyroiditis (Riedel's struma).
Clin Endocrinol (Oxf). 1997 Jul;47(1):107-11.
PMID: 9302380; UI: 97447939
http://thyroidmanager.bsd.uchicago.edu/Chapter19/ch_19__riedels.htm
Riedel BMCL 1896
Die chronische, zur Bildung eisenharter Tumoren führende Entzündung der Schilddrüse.
Verh Dtsch Ges Chir 25:101
Diskussion und Fragen,Anmerkungen
Riedel's Thyroiditis
In 1896 Riedel described a chronic sclerosing thyroiditis, occurring especially in women, that tends to progress inexorably to complete destruction of the thyroid gland and frequently causes pressure symptoms in the neck 43-45. It is exceedingly rare. In the Mayo Clinic series it occurred approximately on-fiftieth as frequently as Hashimoto's thyroiditis. It is approximately twice as frequent in men as in women and is found most often in the 30- to 60- year age group. The thyroid gland is normal in size or enlarged, usually symmetrically involved, and extremely hard. Occasionally involvement may be unilateral. On pathologic examination the gland is replaced by dense fibrosis in which are scattered solitary follicular cells and occasional acini with small amounts of colloid. The fibrosis binds the thyroid firmly to the trachea and the strap muscles, from which it can be separated only with the greatest difficulty (ligneous thyroiditis) 46. The fibrosis may compress the trachea or esophagus. The disease may remain stable over many years, or it may progress slowly and produce hypothyroidism. Dyspnea, dysphagia, hoarseness, and aphonia are caused by the local pressure, and if there is enough pressure on both recurrent laryngeal nerves, there may be stridor. Sometimes the disease is asymptomatic and discovered only incidentally. The pathologic process may advance to complete replacement of the gland, and then symptoms and signs of hypothyroidism appear. Involvement of the parathyroid glands by the fibrotic process may result in hypoparathyroidism 47-49. Rarely, Riedel's thyroiditis may be associated with similar fibrosclerotic processes in other areas, including the lacrimal glands, orbits, parotid glands, mediastinum, lung, myocardium, retroperitoneal tissues, and bile ducts in varying combinations in the syndrome of multifocal fibrosclerositis. Subcutaneous fibrosclerosis has also been noted but it is very rare 50. The occurrence of cerebral sinus thrombosis suggests that Riedel's thyroiditis may cause venous stasis, vascular damage, and possibly hypercoaguability (50a). The results of laboratory tests of thyroid function are usually normal, but about one-third are hypothyroid. The erythrocyte sedimentation rate is not elevated, as in subacute thyroiditis, and there is no leukocytosis. Antithyroid antibodies are present in 67% of reported cases 43 and a mixed population of B- and T-cells is present in the thyroid, suggesting an autoimmune etiology or association. The occurrence of marked tissue eosinophilia and the extracellular deposition of eosinophil granule major basic protein suggests a role for eosinophils and their products in the development of fibrosis in Riedel’s thyroiditis 51. Although there is no specific therapy for Riedel's thyroiditis, there may be occasionally a gratifying response to corticosteroid treatment (51a,b).
http://www.endocrine-surgeon.co.uk/thyroid/thyroiditis/thyroiditis5.htm
What is Riedels Thyroiditis
This is an exceptionally rare condition .In 25 years the author has only seen 6 cases. Although the patient has a woody hard thyroid, the disease does not arise from the thyroid gland. The soft tissue in the neck is invaded by fibrous tissue, which strangulates the neck structures causing swallowing and breathing difficulties. Treatment is difficult; steroids may control the progress of the disease but the effect is usually temporary. The breast anti-cancer drug tamoxifen may also be effective. Surgery is limited to freeing the windpipe and is horrendously difficult.