Case Report: Concurrent thyroid tuberculosis and tuberculous lymphadenitis initially misdiagnosed as malignancy by

Background: Tuberculous lymphadenitis (TBL) is a common manifestation of extrapulmonary tuberculosis (EPTB). However, establishing a definitive diagnosis can be challenging, particularly in primary healthcare settings, when the clinical presentation is atypical or when TBL coexists with another rare form of EPTB-thyroid tuberculosis (TB). Whether primary or secondary, TB remains an exceedingly uncommon clinical entity, even in the context of the persistently high overall prevalence of tuberculosis in China. Thyroid tuberculosis accounts for approximately 0.1%-0.4% of all thyroid diseases, with an even lower incidence of primary thyroid involvement. Herein, we report a case in which Case description: The patient was a 68-year-old male presenting with a 10-day history of a palpable neck mass. Thyroid ultrasonography revealed multiple bilateral thyroid nodules classified as TI-RADS category 4b, accompanied by markedly elevated serum anti-thyroglobulin antibody (TGAb) and anti-thyroid peroxidase antibody (TPOAb) levels. An enlarged lymph node was detected in the right cervical region. An Conclusion: This case highlights the importance of considering the possibility of thyroid tuberculosis in clinical practice. With the increasing detection of thyroid nodules during routine examinations, accurate differentiation between benign and malignant etiologies is crucial. Incorporating tuberculosis infection into the differential diagnosis may help prevent unnecessary surgical interventions for suspected thyroid malignancy.