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Head and Neck Imaging

Riedel's thyroiditis

rare disease characterised by infiltration of the thyroid gland and surrounding structures by dense fibrotic tissue. The fibrosis is associated with a lymphoplasmocytic infiltrate. The histological findings are similar to retroperitoneal fibrosis . The disease may be confined to the neck, or associated with fibrotic lesions in other locations, such as the mediastinal or retroperitoneal area ( multifocal fibrosclerosis ).
The disease has a female preponderance. Usually, patients present with a growing goitre and breathing difficulties. Clinically, the mass has a very hard consistency, and is fixed to the neighbouring structures, resembling a malignant tumour.
CT and MR studies shows an enlarged and hypo-enhancing thyroid gland with tracheal and/or esophageal compression. Invasion of nearby soft tissues may be seen (Fig. 1). The lesion appears hypo-echogenic on ultrasound studies.

RH

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Fig. 01a

Contrast-enhanced axial CT-images.
Riedel's thyroiditis, Fig. 01a (a)
Riedel's thyroiditis, Fig. 01b (b)