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NBME 23 Answers

nbme23/Block 2/Question#20 (31.8 difficulty score)
A 47-year-old woman has had a goiter for 10 ...
Replacement of thyroid parenchyma by lymphoid cells🔍

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submitted by notadoctor(153),
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submitted by chris07(55),
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m'I ssiggneu htta iescn tihs is oshi'hoasmt ttah a osbpiy fo eth idohrty owlud hswo the ithydor lngad pmtlceyeol eldfugne yb catangikt cth.msploeyy vOer mite to,hghu ldwuont' het roidyht be tyecelomlp ysedorted nda fit?coibr

dr.xx  Progressive thyroid cell damage can change the apparent clinical picture from goitrous hypothyroidism to that of primary hypothyroidism, or "atrophic" thyroiditis. The pathological features are atrophic thyroid gland with lymphocytic infiltration and fibrous tissue replacing normal thyroid parenchyma. +  
paulkarr  I was thinking that "Diffuse fibrosis" was trying to point to IgG4 Riedel Thyroiditis rather than Hashimoto's. +6  
spow  It's only been 10 months, per the question stem. This probably isn't long enough for fibrosis to be correct +1