Definition
Benign disease characterized by accumulation of dark brown pigment in the thyroid gland. It is more frequently secondary to minocycline and related tetracycline therapy, although it has been also observed in patients treated with antibiotics other than tetracyclines and antidepressant including doxepin, lithium carbonate, or tricyclic antidepressants (Nose 2016; Barras et al. 2018). More recently, intraoperative use of indocyanine green has been found as a new cause of black thyroid (Chernock et al. 1997).
Clinical Features
Incidence
Not known
Age and Sex
The mean age of patients with black thyroid has been reported to be 54.3 years. There is no apparent gender predilection (Ibrahim et al. 2015).
Site
Thyroid
Treatment
Thyroid function is typically normal, and only a few cases have been reported to be associated with hyperthyroidism (Tacon et al. 2008). Since black thyroid represents an incidental finding at surgery or autopsy (Hetch et al. 1999), no specific treatment is...
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References and Further Reading
Barras, J. L., Sarro, R., Bongiovanni, M., & La Rosa, S. (2018). Antidepressant-related black thyroid. Endocrine Pathology, 29, 86–88.
Bruins, N. A., Oswald, J. E., Morreau, H., Kievit, J., Pavel, S., & Smelt, A. H. (2007). Papillary thyroid carcinoma in a patient with sarcoidosis treated with minocycline. The Netherlands Journal of Medicine, 65, 185–187.
Chernock, R. D., & Jackson, R. S. (2017). Novel cause of ‘black thyroid’: Intraoperative use of indocyanine green. Endocrine Pathology, 28, 244–246.
Hecht, D. A., Wenig, B. M., & Sessions, R. B. (1999). Black thyroid: A collaborative series. Otolaryngology and Head and Neck Surgery, 121, 293–296.
Ibrahim, Y., Crawford, B. E., Murci, M., Masoodi, H., Khan, A. N., Hu, T., et al. (2015). Thyroid cancer in black thyroid glands: The effect of age and race. ORL: Journal for Otorhinolaryngology and Its Related Specialties, 77, 33–38.
Lüllmann, H., Lüllmann-Rauch, R., & Wassermann, O. (1978). Lipidosis induced by amphiphilic cationic drugs. Biochemical Pharmacology, 27, 1103–1108.
Nosé, V. (2016). Drug- and radiation-induced changes and pigment accumulation. In O. Mete & S. L. Asa (Eds.), Endocrine pathology (pp. 422–424). Cambridge: Cambridge University Press.
Pastolero, G. C., & Asa, S. L. (1994). Drug-related pigmentation of the thyroid associated with papillary carcinoma. Archives of Pathology & Laboratory Medicine, 118, 79–83.
Reid, J. D. (1983). The black thyroid associated with minocycline therapy. A local manifestation of a drug-induced lysosome/substrate disorder. American Journal of Clinical Pathology, 79, 738–746.
Senba, M., Toda, Y., & Yamashita, H. (1988). Black thyroid associated with minocycline therapy: Histochemical and ultrastructural studies on the brown pigment. Israel Journal of Medical Sciences, 24, 51–53.
Tacon, L., Tan, C. T., Alvarado, R., Gill, A. J., Sywak, M., & Fulcher, G. (2008). Drug-induced thyroiditis and papillary carcinoma in a minocycline-pigmented black thyroid gland. Thyroid, 18, 795–797.
Thompson, A. D., Pasieka, J. L., Kneafsey, P., & DiFrancesco, L. M. (1999). Hypopigmentation of a papillary carcinoma arising in a black thyroid. Modern Pathology, 12, 1181–1185.
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La Rosa, S. (2021). Black Thyroid. In: van Krieken, J. (eds) Encyclopedia of Pathology. Encyclopedia of Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-28845-1_5181-1
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DOI: https://doi.org/10.1007/978-3-319-28845-1_5181-1
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