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Granulomatous thyroiditis is also referred to as de Quervain or subacute thyroiditis. It is a self-limiting process that usually presents in middle-aged women with sore throat, fever, malaise, painful swallowing, and a tender enlarged thyroid. The gland may be enlarged asymmetrically, sometimes clinically mimicking carcinoma. Microscopic findings include marked inflammation, ill-defined granulomas contain foreign body giant cells, and fibrosis.