A pathological condition in which the functional tissue of the thyroid parenchyma is replaced by a connective tissue component is called fibroid thyroiditis, or Riedel thyroiditis. Often, fibrotic changes affect not only the gland itself, but also nearby anatomical structures, such as neurovascular bundles or the trachea. The main clinical manifestation of this disease is a feeling of squeezing in the neck. In some cases, the resulting seal is so large in size that it begins to be determined visually. The main method of treatment in this pathological process is surgery. As a rule, it is quite effective, relapses are extremely rare. However, if you do not engage in the treatment of fibrous thyroiditis, there is a likelihood of developing hypothyroidism or myxedema.

For the first time, fibrous thyroiditis was described in the late nineteenth century by the German physician B. Riedel, after whom he was later named. The thyroid gland is rarely subjected to fibrous degeneration. The overall prevalence of this pathology is approximately five cases per ten thousand population. It is worth noting that such a pathological process can develop at any age, however, a certain rise in the incidence rate is observed in the age range from thirty-five to sixty years. Female representatives are somewhat more likely than men to develop this disease. In addition to the above complications, there is a small likelihood of malignant transformation in fibrous thyroiditis.

Currently, scientists around the world can not unambiguously answer the question of why Riedel’s thyroiditis is formed. For a long time, it was assumed that the disease has an autoimmune nature. It was believed that   thyroid   changes as a result of the fact that the immune system begins to exert aggression against the cells of its own body. However, it was not possible to confirm this theory due to the fact that the corresponding antibodies were not found in the patients’ blood.

Another theory claimed that the subacute thyroiditis is the root cause of such a disease. Multiple studies have been conducted that could not explain the transition of the granulomatous inflammatory process to the fibrous stage.

To date, the largest role in the formation of fibrous thyroiditis is assigned to various viruses. It is believed that viruses penetrate the tissue of the thyroid gland through the hematogenous or lymphogenous pathway and provoke the occurrence of an inflammatory reaction there, which leads to the proliferation of fibrous tissue. As we have said, this disease is often combined with fibrous lesions and other nearby anatomical structures. In addition, with this pathological process, concomitant fibrous changes in the retroperitoneal space, bile ducts, and so on are often found. This indicates the systemic origin of this pathology.

Initially with Riedel’s thyroiditis   thyroid   inflamed. Against the background of the inflammatory process, increased collagen synthesis and intensive proliferation of fibrous tissue are noted . Gradually, the connective tissue component replaces an increasingly large area of ​​the parenchyma, and a compacted element, called goiter, is formed. At large sizes, the goiter exerts pressure on adjacent vessels and nerves, the esophagus and the trachea. From a morphological point of view, the pathological foci are represented by a dense consistency and a slightly bumpy surface. With a prolonged course of this disease, a gradual decrease in the level of thyroid hormones is observed.

Symptoms characteristic of fibrous thyroiditis

Fibrous thyroiditis has a chronic course. At the beginning of its development, any symptoms, as a rule, are absent. In most cases, a few years pass from the onset of the disease to the appearance of the first complaints. Clinical manifestations occur at a time when the goiter has increased so much that it began to squeeze the surrounding tissue.  

When the adjacent tissues are crushed, symptoms such as a pressing feeling localized in the anterior surface of the neck, discomfort when swallowing, difficulty breathing, change in timbre of the voice and so on are noted. Sometimes a sick person says that he has a foreign body in his throat.

The severity of associated clinical manifestations will directly depend on how strongly the esophagus and trachea are compressed. First of all, it concerns such symptoms as shortness of breath and problems with swallowing. Some patients indicate shortness of breath only during physical exertion, and others – severe difficulty in breathing, even at rest. It is worth noting that such a pathological process is not accompanied by pain in the projection of the gland.

Diagnosis and treatment of the disease

This disease can be suspected already on the basis of palpation examination. The most informative diagnostic method, which is shown to absolutely all patients, is ultrasound. That it will allow to identify foci of fibrous replacement and assess their size. If necessary, the survey plan is complemented by multislice computed tomography. Another important method aimed at differential diagnosis is a biopsy followed by histological examination of the material obtained.

In this pathological process, surgical intervention is prescribed. Its volumes are selected individually depending on how much fibrous tissue has grown. In the postoperative period, it is necessary to choose thyroid hormone replacement therapy, especially in those cases where the entire thyroid gland has been removed.

Prevention of fibrous lesions of the thyroid gland

Talk about   prevention   fibroid thyroiditis is not possible due to the fact that the exact reasons for its development at the moment is not installed.