03-12-2006, 05:24 AM
A perimenopausal woman presents with increasing swallowing difficulty and fatigue. Physical examination reveals that her thyroid is enlarged (palpable goiter). Laboratory examination of her serum reveals T4 of 4.9 mg/dL, free T4 of 2.5 ng/dL, and TSH of 5.5 mIU/mL. No thyroid-stimulating immunoglobulins are identified in the serum, but antimicrosomal antibodies are present. Which one of the following histologic findings, if present in a thyroid biopsy from this individual, would be most consistent with a diagnosis of Hashimoto�s thyroiditis?
A. Lymphocytic infiltrate without follicle formation
B. Intense lymphoplasmacytic infiltrate with lymphoid follicles and scattered oxyphilic cells
C. Hyperplasia of follicular cells with scalloping of colloid at the margin of follicles
D. Granulomatous inflammation with multinucleated giant cells surrounding fragments of colloid
E. Dense fibrosis within the thyroid gland extending into adjacent soft tissue
A. Lymphocytic infiltrate without follicle formation
B. Intense lymphoplasmacytic infiltrate with lymphoid follicles and scattered oxyphilic cells
C. Hyperplasia of follicular cells with scalloping of colloid at the margin of follicles
D. Granulomatous inflammation with multinucleated giant cells surrounding fragments of colloid
E. Dense fibrosis within the thyroid gland extending into adjacent soft tissue