The pyramidal lobe is a thin upward finger of thyroid tissue that rises from the isthmus, more often on the left, toward the hyoid bone. Present in roughly half of people, it is a remnant of the lower end of the thyroglossal duct, the track along which the thyroid descended from the tongue in the embryo.
| Location | Rising from the upper border of the isthmus or adjacent lobe, usually left of the midline, toward the hyoid bone |
|---|---|
| Secretes |
|
| Blood Supply | Branches of the superior thyroid arteries |
| Lymphatic drainage |
Contains ordinary thyroid follicles and adds a small amount to thyroid hormone production; mainly important as an anatomical and surgical landmark.
Surgeons look for the pyramidal lobe during total thyroidectomy because leaving it behind can cause recurrent goitre or persistent uptake on post-operative radioiodine scans. It may be tethered to the hyoid by a fibrous or muscular band (levator glandulae thyroideae). It lies along the same track as thyroglossal duct cysts.
An overlooked pyramidal lobe that keeps producing hormone or takes up radioiodine after a supposedly total thyroidectomy.
A midline neck cyst along the same embryological track, which moves upward when the tongue is protruded.
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