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Biomedical subjects

F Matsuzuka

Publications and source records attributed to F Matsuzuka.

At least 73 records · Page 4Linked to original sources

Immunologic and immunohistochemical studies on chronic lymphocytic thyroiditis with or without thyroid lymphoma.

The local immunologic phenomena in the thyroid gland of 16 patients with chronic lymphocytic thyroiditis (CLTH) were investigated; 5 of these cases were associated with thyroid non-Hodgkin's lymphomas (NHL). All patients were admitted because of struma, growing slowly in patients with CLTH alone and rapidly in those with associated thyroid NHL. CLTH was confirmed by histologic findings, including the presence of lymphoid follicles or thyroid autoantibodies in the serum in all 16 patients. Immunologic study revealed that all thyroid NHL were of the B cell type. Surface maker study of suspended cells showed that the percentages of E-rosette-forming cells in patient with CLTH and thyroid NHL (38.0 +/- 10.0%) and in patients with CLTH alone (45.0 +/- 11.9%) were between those of B cell NHL of lymph node and B cell hyperplasia reported by others. Immunohistochemical studies confirmed the reactive nature of lymphoid follicles. Subset distribution of T and B lymphocytes in patients with CLTH and thyroid NHL markedly contrasted with that in patients with CLTH alone: an increased ration of CD8+ cells (suppressor/cytotoxic cell) to CD4+ cells (helper/inducer cell). There was a marked increase in the number of immunosuppressive acidic-protein(IAP)-containing macrophages in the thyroid lesion and serum IAP level in patients with thyroid NHL. These findings provide evidence of a difference in the local immunologic conditions in CLTH alone compared to CLTH complicated by thyroid NHL.

Adult↗

Detection of thyroid microsomal and thyroglobulin antibodies by new sensitive radioimmunoassay in Hashimoto's disease; comparison with conventional hemagglutination assay.

We evaluated clinical usefulness of thyroid microsomal antibody (MCAb) and thyroglobulin antibody (TGAb) measured by new sensitive radioimmunoassays (RIA). These assays are simple and reproducible; the intra- and inter-assay coefficients of variation were 3.6-6.8% and 6.6-13.2% in the MCAb assay, and 3.2-7.7% and 7.6-12.3% in the TGAb assay, respectively. In 126 patients with Hashimoto's disease, the antibody activity determined by this RIA correlated with that determined by the hemagglutination assay (HA) (r = 0.848 for MCAb, r = 0.686 for TGAb, p less than 0.001). MCAb was detected by RIA in all of 115 HA-positive and 4 of 11 HA-negative patients, and TGAb by RIA in all of 84 HA-positive and 29 of 42 HA-negative patients: the prevalence of MCAb was 94% and that of TGAb was 90% in the disease. Moreover, some showed high antibody activity only in RIA. In another group of 14 patients with biopsy-proved Hashimoto's disease with no antibody activity by routine HA tests, serum MCAb was detected in 3 (21%), TGAb in 11 (79%), and both activities in 2 (14%). Our results indicate that (1) the RIA tests are more sensitive than the conventional HA test, and that (2) the present RIA test for TGAb is more sensitive than that for MCAb in detecting autoimmune abnormalities, especially in patients with biopsy-proved Hashimoto's disease who give negative results in the HA test.

Adult↗

Unusual thyroid scintigrams in Plummer's disease during methimazole therapy. Conversion of hot to hypofunctional nodules.

Thyroid scintigrams of two women (aged 48 and 58) with Plummer's disease showed unusual radioiodine accumulation during treatment with methimazole (MMI). Before MMI therapy, the scintigrams revealed most of the radioiodine uptake only in the nodules of the patients and very little uptake in the non-nodular portions of the thyroid. After initiation of MMI therapy, scintigrams performed at three and eight months revealed that the hot nodules had become hypofunctional and that the surrounding tissues had normal radioiodine accumulation. The findings indicate that the nodules in Plummer's disease continue to concentrate MMI selectively compared with normal surrounding thyroid tissue during therapy.

Adenoma↗

Hashimoto's thyroiditis manifesting monoclonal lymphocytic infiltration.

Hashimoto's thyroiditis (HT) and lymphoma are sometimes difficult to distinguish between. Moreover, lymphoma sometimes develops in a thyroid gland from pre-existing HT. Open- or large-needle biopsy usually distinguishes between them; the specimen may be examined histologically and subjected to immunohistochemistry. Another possible method of examination is fine-needle aspiration biopsy (FNAB). The cells obtained may be evaluated cytologically, and subjected to flow cytometry, using various antibodies. In this study, anti-kappa and anti-lambda antibodies are especially important, as a gross predominance of kappa or lambda B lymphocytes infiltrating the thyroid is evidence for a B cell monoclone. In this study, 15 patients were selected because of their rapidly growing goitres. They all underwent FNAB. Five had cytology typical of HT, and no evidence of monoclonality on flow cytometry. They were diagnosed as HT without further histopathology. The remaining 10 patients had cytology suspected of lymphoma, or evidence of monoclonality on flow cytometry, or both. These patients underwent open- or large-needle biopsy. Only three of them were diagnosed histopathologically as lymphoma; the other seven were diagnosed histopathologically as HT, making 12 cases of HT in all. Five of these 12 cases, and one of the three cases of lymphoma showed flow cytometrical evidence of monoclonality; thus evidence of monoclonality from FNAB, while interesting, does not necessarily serve to differentiate between HT and lymphoma. Furthermore, the immunohistochemical assessment of monoclonality did not correlate with the flow cytometrical assessment. Follow-up evidence will be required to discover whether those patients with a B cell monoclone in their HT are the ones who develop a lymphoma.

Aged↗

Thyroid-stimulating antibody and thyrotropin-binding inhibitory immunoglobulin activity in hypothyroid patients who subsequently developed thyrotoxicosis.

Although abnormal thyroid-stimulating and -blocking antibodies have been demonstrated in hyperthyroid and hypothyroid patients with autoimmune thyroid disorders, a direct correlation is not always observed. Thyroid-stimulating antibody, thyrotropin-binding inhibitory immunoglobulin, and thyroid-stimulating blocking antibody levels were determined in three hypothyroid patients who subsequently developed hyperthyroidism. Thyroid-stimulating antibodies levels were normal in one, elevated in another, and unmeasured in the third hypothyroid patient, but became elevated in all patients with the onset of hyperthyroidism. There was discordance, however, in one patient who had markedly elevated thyroid-stimulating antibodies and TSH-binding inhibitory immunoglobulin levels when she was hypothyroid. The data indicate that thyroidal responses to the abnormal stimulating antibodies may differ among patients with autoimmune thyroid disease.

Adult↗

Possible disorder of B-cell-related surveillance and malignant lymphoma of the thyroid.

Malignant lymphoma of the thyroid has been shown to be of B-cell origin. To clarify its genetic origin, we have investigated HLA-A, B, C, and DR antigens, and the immunoglobulin G (IgG) heavy-chain allotype, Gm, in such patients. There was no correlation between the occurrence of malignant lymphoma of the thyroid and the HLA antigens tested, but patients with this lymphoma had significantly lower frequency of the Gm1,21 haplotype than healthy persons. These results suggested a disorder of surveillance related to B-cells may be involved in the pathogenesis of malignant lymphoma of the thyroid.

Adult↗

Correlation of chromosome abnormalities with clinical characteristics in thyroid lymphoma.

Karyotypes from seven patients with thyroid lymphoma were studied before treatment. When the cytogenetic results were correlated with the clinical data, it became evident that there are two distinct groups of patients with thyroid lymphoma. In a group of patients with solely numerical abnormalities the disease is associated with a rather long duration from the onset of goiter to the time of operation for lymphoma, with abnormal thyroid function, and with positive tests for antithyroid autoantibodies. Two of four patients in this group showed trisomy 22; the remaining two showed a loss of a sex chromosome. The other group of patients with solely structural abnormalities is associated with a short duration from the onset of goiter to the time of operation, with normal thyroid function, and with the trend of negative tests for autoantibodies. Two of three patients in this group showed a 14q+ abnormality. These results indicate that there are two distinct type of thyroid lymphoma, chromosomal changes of which are implicated as pathogenetic factors in lymphomagenesis of different mechanisms.

Aged↗

Intrathyroidal HLA-DR-positive lymphocytes in Hashimoto's disease: increases in CD8 and Leu7 cells.

The peripheral and intrathyroidal HLA-DR-positive (DR+) lymphocyte subsets that were activated in vivo in patients with Hashimoto's disease (HD) were examined by two-color flow cytometry with monoclonal antibodies against CD3, CD4, CD8, Leu7, CD19, and HLA-DR antigens. The proportions of total DR+ cells in peripheral lymphocytes and the proportions of DR+ cells in the CD3+, CD4+, and Leu7+ lymphocytes were higher in patients with HD than in normal controls. Furthermore, the proportions of total DR+ cells among intrathyroidal lymphocytes isolated from thyroid tissue of individuals with HD were higher than those in their peripheral lymphocytes. Interestingly, the proportions of DR+ cells among the CD3+, CD8+, and Leu7+ lymphocytes in the thyroid were greatly increased. These data indicate that (i) CD3+ T, especially CD4+ T helper/inducer, lymphocytes and Leu7+ NK/K cells are activated in peripheral blood in Hashimoto's disease and that (ii) CD3+ T, especially CD8+ T suppressor/cytotoxic, lymphocytes and Leu7+ NK/K cells are predominantly activated in Hashimoto's goiter, suggesting an increase of cell-mediated cytotoxicity in the thyroid in Hashimoto's disease.

Adult↗

Primary thyroid lymphoma: comparison of CT and US assessment.

Sixteen patients with primary thyroid lymphoma were studied with computed tomography (CT) and ultrasonography (US), and findings were compared. In 13 of 16 patients, detection of the primary tumor with US and CT were comparable. US was superior in one case, and CT in another. One tumor was not detected with either technique. Thyroid lymphomas appeared as extremely hypoechoic masses intermingled with echogenic structures. Although echogenicity of unaffected thyroid tissue was also low because of coexisting Hashimoto thyroiditis, thyroid lymphomas were relatively well differentiated as markedly hypoechoic areas. Five tumors showed contiguous spread into both thyroid lobes. US and CT were equally sensitive in detection of superficial lymphomatous nodes (seven of 16 cases). CT was superior to US in the definition of tumor extent in two patients with intrathoracic tumor extension and in one with laryngeal invasion. In patients with suspected thyroid lymphoma, CT should be the primary radiologic technique used for diagnosis and staging; US will be useful in local follow-up.

Aged↗

Malignant lymphoma of the thyroid and Epstein-Barr virus.

We have investigated the specific immune response to Epstein-Barr virus (EBV) of peripheral blood mononuclear cells (PBMC) from patients with malignant lymphoma of the thyroid. Coculture of PBMC and EBV resulted in EBV cell transformation and regression which was assayed by an EBV-induced B cell focus-regression assay technique. The EBV had been isolated from mouthwash samples. The specific immune response to EBV by outgrowth inhibition in PBMC from untreated EBV-seropositive patients with malignant lymphoma was significantly decreased when compared to PBMC from EBV-seropositive healthy subjects (p less than 0.05). This observation is at least consistent with the possibility that B-cell proliferation after continuous or recurrent EBV infection could be a causative factor or may potentiate malignant lymphoma of the thyroid.

Aged↗

Marked increase of CD5 + B cells in hyperthyroid Graves' disease.

We examined the proportions of B lymphocytes bearing CD5 cell surface antigen (CD5+ B cells), which are capable of making autoantibodies, in peripheral blood from patients with various thyroid diseases. The level of CD5+ B cells was markedly increased (>9.0%) above the normal range (0.5-7.7%) in untreated, hyperthyroid patients with Graves' disease, although about 10% of the patients had no detectable serum thyroid-stimulating hormone (TSH) receptor antibody (TRAb). However, the levels of CD5+ B cells were normal in untreated patients with destructive thyrotoxicosis due to aggravation of Hashimoto's thyroiditis or subacute thyroiditis. In patients with stimulated hyperthyroid Graves' disease the levels of CD5+ B cells were correlated with those of thyroid hormones and TRAb, all significantly increased. However, once hyperthyroidism was controlled by anti-thyroid drugs, CD5+ B cells were decreased, followed in turn by reduction of TRAb. We conclude that the proportion of CD5+ B cells is useful as a therapeutic index and for diagnosis of Graves' disease and its differentiation from destruction-induced thyrotoxicosis.

Adult↗

Thyroidal prelymphoma.

We treated a 32-year-old man with "thyroidal prelymphoma", morphologically resembling Hashimoto's thyroiditis and associated with monoclonal gammopathy (IgG, lambda). Immunohistochemistry revealed intracytoplasmatic monoclonal immunoglobulin (IgG, lambda) containing lymphoid cells in the interstitium of the thyroid tissue. After total thyroidectomy had been performed, the monoclonal immunoglobulin disappeared. Three years have passed since the surgery and this writing, there has been no recurrence. The existence of thyroidal prelymphoma suggests that chronic antigenic stimulation might produce lymphocytes which are more susceptible to neoplastic change (Hashimoto's thyroiditis----thyroidal prelymphoma----malignant lymphoma of the thyroid).

Adult↗

Immunologic and immunohistologic analysis of 27 cases with thyroid lymphomas.

Twenty-seven patients with stages I or II thyroid lymphomas were investigated immunologically. Approximately 60% of these patients had a goiter for longer than 1 year. Both the tests for serum antithyroid antibodies and histologic findings of the resected specimens showed that chronic lymphocytic (autoimmune) thyroiditis was usually present. The tumors were classified histologically as seven cases of follicular lymphomas and 20 cases of diffuse lymphomas. Immunocytologic study on suspended cells and immunohistologic study on frozen tissue sections showed that neoplastic cells in 22 of 27 cases expressed restricted immunoglobulin light chains. In remaining five cases, the neoplastic cells reacted with B-1, Leu-10, and/or Leu-14. These results indicate that thyroid lymphomas are exclusively B-cell-derived tumors.

Adult↗

Thyroid carcinoma and hot nodule.

A 70-year-old woman presented with a nodule in the thyroid gland. 131I scintigraphy of the gland showed a hot nodule. Histology of the resected thyroid revealed a papillary adenocarcinoma. Although a thyroid carcinoma with a hot nodule seen on the radioiodine isotope scan is a very rare occurrence, it is clinically very important because it may indicate a thyroid malignancy.

Adenocarcinoma, Papillary↗