Journal of the Louisiana State Medical Society
P athology I mage of the M onth
Black Thyroid
Christin Tsao, MD; Robin R. McGoey, MD
A 54-year-old Caucasian male had a witnessed collapse on the street. He was transported to the emergency department and subsequently pronounced dead. An unlimited autopsy examination was conducted under authorization of the coroner. Medical record review later revealed that the decedent had a history of alcohol abuse, chronic obstructive pulmonary disease, congestive heart failure, and chronic osteomyelitis treated by minocycline 100 mg twice daily. Autopsy revealed the cause of death to be ruptured gastroesophageal varices with nearly one liter of recent hemorrhage in the stomach and gastrointestinal tract. Other findings compatible with a history of alcoholism included hepatosplenomegaly, hepatic steatosis, and early bridging fibrosis. The decedent’s thyroid was multinodular and enlarged at 50 gm. The thyroid gland, in its entirety, is shown below with serial sections made longitudinally through the gland capsule to reveal the underly- ing parenchyma.
Figure 1: Gross image of the thyroid gland eviscerated at autopsy, serially sectioned longitudinally, that shows charcoal black pigmentation of the gland parenchyma extending full thickness from the capsular surface.
What is the diagnosis in this thyroid gland and what is the likely cause?
134 J La State Med Soc VOL 166 May/June 2014
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