International Journal of Health Sciences and Research Vol.10; Issue: 6; June 2020 Website: www.ijhsr.org Case Report ISSN: 2249-9571 International Journal of Health Sciences and Research (www.ijhsr.org) 239 Vol.10; Issue: 6; June 2020 Diffuse Lipomatosis of Thyroid Masquerading as Nodular Goitre Meenu Gill 1 , Gauri Munjal 2 , Pooja Pawaria 3 , Zeany Cheran Momin 3 , Sumiti Gupta 1 , Bharti Saklani 3 , Rajeev Sen 4 1 Professor, 2 Senior Resident, 3 Junior Resident, 4 Sr. Professor & Head, Dept. of Pathology, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India Corresponding Author: Zeany Cheran Momin ABSTRACT Diffuse thyroid lipomatosis is an exceedingly rare histopathological condition of thyroid classically characterized by diffuse swelling and fatty infiltration within the thyroid stroma. We report a case of 40 year old female who presented with a midline swelling in neck since 7 years with a recent history of compressive symptoms. On evaluation, goitre of thyroid gland was revealed on computed tomography. She underwent subtotal thyroidectomy and the final diagnosis of diffuse thyroid lipomatosis was confirmed based on histopathology. Keywords: thyrolipoma; histopathology; goiter; neck swelling; lipomatosis; thyroid. INTRODUCTION Thyroid lipomatosis is defined as a progressive enlargement of thyroid gland by diffuse infiltration of mature adipose tissue intermixed with follicles and lack of encapsulation. [1] It is an extremely rare condition and the first ever case was reported by Dhayagude in 1942. [2] We report a case of thyrolipomatosis in a 40 year old patient presenting with respiratory distress. CASE REPORT A 40 year old female patient presented with a history of diffuse midline swelling for the past 7 yrs. With recent increase in the size of swelling, she developed dysphagia, dyspnoea and was admitted in emergency with respiratory distress since 2 days. There were no complains of fever, palpitation, tachycardia or weight loss. Thyroid function tests were within normal limits. Plain radiographs of the chest were unremarkable. Computed tomography scan revealed goitrous enlargement of thyroid gland (Figure-1a and 1b). Figure 1:-1a and 1b- Pre-operative computed tomography scans showing diffuse enlargement of both the lobes of thyroid gland including the isthmus revealing heterogenous enhancement and no obvious cystic/necrotic component. Fine needle aspiration cytology (FNAC) was performed in which 10 ml colloid admixed with blood was obtained and was inconclusive. A clinical diagnosis of colloid goitre with tracheal compression was made and subtotal thyroidectomy was 1b 1a