Figure 1-26. Suppurative thyroiditis is usually an acute disease that results from bacterial infections, but, on rare occasions, tuberculosis and fungi may infest the thyroid gland. A, Coccidioidomycosis thy-roiditis in a patient on long-term corticosteroids for systemic vasculitis. Linear cuts were made in the thyroid tissue to show evidence of central necrosis. Note the large pyramidal lobe that is also involved. B, Photomicrograph of the specimen in A showing a necrotic area of the thyroid gland formed by mature spherules of Coccidioides immitis filled with endospores (arrow) (hematoxylin and eosin; x100 original magnification). C, Photomicrograph of tuberculous thyroiditis reveals multiple giant cells and acid-fast bacilli (hematoxylin and eosin; x250 original magnification).
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