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Immunocytochemistry of anaplastic carcinoma of thyroid gland.

Twelve anaplastic thyroid carcinomas were investigated with a panel of antibodies. The squamoid and giant cell anaplastic carcinomas showed coexpression of cytokeratin and vimentin in 66% of the cases. Reactivity for A-1-AT and A-1-ACT antiserum appeared when the spindle cell component became prevalent. The antidesmoplakin antibody can be employed on cryostat sections in differential diagnosis between sarcoma and carcinoma of the thyroid.

Adult↗

Quantitative indicators of sonographic image of thyroid gland and their relation to antithyroid antibodies in Hashimoto's lymphocytic thyroiditis.

Sonography is a widely used non-invasive diagnostic tool and its main advantage is low cost in comparison with other diagnostic methods such as immunological analyses. In this work it is presented the relation between a sonographic image of thyroid gland and an immunological status of the patients with Hashimoto's lymphocytic thyroiditis (chronic inflammation of the thyroid gland). The results, evaluated on a set of 740 B-mode sonographic images from 37 subjects, show that raw values of individual image pixels in sonogram of thyroid gland with presence and without presence of anti-thyroid antibodies are significantly different (means 31.87 and 44.56; standard deviations 8.6 and 11.82; t = 3.4; p = 0.0017) and that they can be used for the prediction of presence of anti-thyreoglobulin and anti-thyreoperoxidasis antibodies. This result suggests the possibility to use this method in clinical diagnostic process for reducing the costs. Also the correlation between the image features and the level of antibodies was examined. The highest correlation was found for inverse difference moment and the level of anti-thyreoperoxidasis (coefficient of determination 0.43).

Autoantibodies↗

THYROID gland.

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Humans↗

Tissue specific binding of lymphocytes to the thyroid gland of BB/W rats may be an early event in the development of thyroiditis.

Thyroiditis occurs in about 50% of diabetic Bio Breeding/Worcester (BB/W) rats. In order to investigate the earliest stages of lymphocyte homing to the thyroid gland in the development of experimental autoimmune thyroiditis, we measured the amount of trapping of peripheral blood lymphocytes (PBL) from BB/W rats to the thyroid gland of syngeneic recipient animals. PBL, from donor normal or diabetic BB/W rats, labelled with 51Cr, were injected, i.v., into normal, "potentially diabetic" or diabetic BB/W recipients. After 24 hr the rats were sacrificed and the radioactivity of selected individual organs counted. Results were calculated as % binding of 51Cr-labelled PBL/unit weight of tissue and expressed as a binding index by comparing to binding to recipient blood lymphocytes. A significant binding index was taken as greater than 1.0. PBL from diabetic or normal donor BB/W rats were shown to bind significantly to the thyroid gland of 8 out of 19 "potentially diabetic" or diabetic recipient syngeneic rats, but to none of the normal (non diabetic) recipients tested. Sixty percent of "potentially diabetic" BB/W rats and 50% of diabetic rats at 3-4 months of age showed a significant level of binding of donor lymphocytes from syngeneic diabetic or normal animals to their thyroid gland, while, at 5-6 months the proportion of recipient rats giving positive tests was much less (17%). The source of the donor lymphocytes (diabetic, or normal) did not significantly influence the binding. Lymphocyte binding to pancreas was not significantly greater than to control tissues.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

The thyroid gland.

Disorders of the thyroid gland are frequently unrecognized and untreated by the attending physician and present the anesthesiologist with a diagnostic and therapeutic challenge. Very large goiters distort and compress the larynx and require an experienced anesthesiologist for safe intubation. If surgery is elective and can be postponed in patients suspected of being hypo- or hyperthyroid, there is sufficient time to permit the anesthesiologist and the attending physician to obtain appropriate tests of thyroid function and institute appropriate therapeutic measures to restore the metabolic rate to normal. When there is insufficient time to confirm a clinical diagnosis of thyroid disease, the anesthesiologist is faced with important therapeutic decisions. It is the author's opinion that therapeutic intervention is, in most instances, preferable to therapeutic nihilism. In the case of a patient suspected of hypothyroidism, it is usually safe to administer a physiologic replacement dose of thyroxine to support the patient intraoperatively or postoperatively. If hypothyroidism is associated with cardiovascular disease, other debilitating illness, or advanced age, thyroxine must be given with extreme caution in order to avoid dangerous tachyarrhythmias or too rapid acceleration of the metabolic rate. The hyperthyroid patient facing nonelective surgery represents a very serious challenge to the anesthesiologist, since marked accentuation of clinical hyperthyroidism (thyroid storm) is a major risk of such surgery. In such a situation, intravenous propranolol and intravenous iodine are the optimal drugs for a safe and uncomplicated clinical course during and following surgery. In both instances, the anesthesiologist must use skillful clinical judgment in making the appropriate diagnosis and selecting appropriate therapy. Careful and continuous supervision of the patient is necessary during and following surgery and appropriate treatment and support of the patient should be provided until it is safe to discontinue therapy, if necessary, to confirm the diagnosis of thyroid disease. Careful clinical judgment and judicious use of appropriate medication should provide the patient with a smooth and safe intraoperative course and a rapid and uncomplicated postoperative recovery.

Adolescent↗

The relation of thyroid auto-immunity to round-celled infiltration of the thyroid gland.

The relationship between thyroid auto-immunity and the presence of lymphocytes in the thyroid gland has been analysed in patients with Graves' disease, toxic adenoma, and non-toxic nodular goitre. In all these conditions circulating antibody to thyroglobulin was significantly associated with lymphocytic infiltration. No similar correlation was established in the case of the complement-fixing antibody.Complement-fixing antibody was significantly commoner in Graves' disease (diffuse thyrotoxic goitre) than in toxic adenoma and non-toxic nodular goitre. Circulating thyroglobulin antibody probably originates from lymphoid tissue within and around the thyroid gland itself. Overactivity of pituitary thyrotropin may favour immunization to the intracellular (complementfixing) antigen.

Antibodies↗

[C-cells (parafollicular) and medullary cancer of the thyroid gland].

In the human thyroid gland, less than 1% of the cell mass of the organ parenchyma is comprised of C-cells, the typical feature of which is the capacity of produce and accumulate a hypocalcemic hormone, calcitonin. Because of their function, these cells play an important role in the maintenance of homeostasis. Neoplastic proliferation of C-cells results in medullary carcinoma represented by the classical forms and non-medullary apudomas. Morphological, histochemical, and electron microscopic studies demonstrated cytological and histological inhomogeneity of thyroid apudomas and allowed the differential diagnosis criteria for their identification to be outlined.

APUD Cells↗

Malignant paraganglioma of the thyroid gland.

Paragangliomas of the thyroid gland are rare lesions, only four previous cases having been reported in the literature, to our knowledge. We report herein a fifth case, which, to our knowledge, is the first to exhibit malignant behavior manifested by invasion into perithyroidal soft tissue through the wall of the trachea into the tracheal mucosa.

Biopsy, Needle↗

Summary of observations on transplantable tumors of the rat thyroid gland.

Transplantable tumors of the thyroid gland have been produced by feeding of thiouracil (TU) to inbred Fischer 344 rats followed by the transplantation, initially, of pieces of hyperplastic thyroid gland, and in later generations, of pieces of transplanted tissue into similar rats or into rats fed a high iodine diet. In early generations, transplants grew only in the rats fed the TU diet, and this tissue was called dependent, whereas if the tissue grew in rats fed the high iodine diet in the absence of TU, it was called independent. Dependent tumors were, initially, either papillary or of follicles distended with colloid. Later generations of some sublines were cellular or microfollicular in pattern and some became progressively more heterogeneous with later generations. Independent tumors began to appear by the third transplant generation. They were, initially, relatively uniform in pattern, and some tended to remain so, whereas other sublines exhibited some heterogeneity. Tumors had patterns that were cellular, or microfollicular, or follicular or had open follicles, etc.; there was one cellular ascites tumor subline. Other observations were made of vascular patterns, connective tissue, necrosis, and metastases.

Animals↗

[Ultrasonography of the thyroid gland and the pancreas in healthy children and in patients with endocrinological disease].

The thyroid gland and pancreas were ultrasonographically examined in order to determine their normal sizes in children. In 418 healthy children the thickness and width of the right and left lobes of the thyroid gland were measured at the transverse section of the neck. In 145 healthy children the long axis and short axis diameters of the profile of the head and body of the pancreas were measured by the sagittal scanning at the epigastrium. The mean +/- standard deviations as a function of height was determined as the normal size in children. In 23 patients with congenital hypothyroidism and hyperthyropinanemia ultrasonographic findings of the thyroid gland were classified into 4 groups: large thyroid gland image, normal thyroid gland image, small thyroid gland image, and no image of the thyroid gland. The patients in the no image of the thyroid gland group revealed extremely high serum thyrotropin level at the initial diagnosis, and they needed a total replacement dose of l-T4. Thyroid scintigraphy was carried out in 7 of the 23 patients. The ultrasonographic findings coincided with the scintigrams in all 7 patients. We concluded that no image of the thyroid gland by ultrasonography was in accord with thyroid aplasia or ectopic thyroid gland, and large thyroid gland image by ultrasonography was goitorous congenital hypothyroidism. In 18 patients with insulin-dependent diabetes mellitus (IDDM) the size of the pancreas was smaller than in the healthy controls. However there was no correlation between the size of the pancreas and clinical parameters, such as duration of IDDM, mean HbA1 and the insulin dose. In 31 patients with growth hormone deficiency undergoing growth hormone therapy, pancreas size was not different from the healthy controls. Thus it was suggested that in IDDM patients the size of the pancreas was small at the time of onset, and that the growth hormone had morphologically no influence on the pancreas in patients with growth hormone deficiency.

Child↗

[C-cells of the thyroid gland].

In the human thyroid gland, the C-cell system reacts in physiologic and pathologic conditions as an entity and represents an independent endocrine organ. Its special features are its embryology, which relates it to other derivatives of the neural crest, the special histologic methods needed to demonstrate its disseminated C cells, and the obscure physiologic role of its hormone, calcitonin. Although there exist many histopathologic findings, the only C-cell disease of clinical interest is medullary carcinoma, which in its familial form is usually associated with pluriglandular syndromes.

Calcitonin↗

[Arterial supply of the thyroid gland in the human fetuses].

Thyroid arteries were studied in 37 Japanese fetuses from 4 months to 9 months old. The results were as follows: (1) The occurrence of pyramidal lobe was 48.6%. (2) The patterns of the branches arising from the aortic arch were classified into four types. Type A was the most common type and was found in 91.9%. Anomalous types C, G and CG were found in only one each (2.7%). (3) In Type A, the arterial distribution to the thyroid gland was as follows; 1) The superior thyroid artery was found to be a single branch from the parent artery in 100% of cases on the right and in 94.1% on the left, in 2 cases it was found to be a thyro-lingual trunk on the left side. 2) The superior thyroid artery arose from the external carotid artery in 61.8% of cases on the right and in 47.0% on the left, from the divergent portion of the internal and external carotid arteries in 26.5% on both sides and from the common carotid artery in 11.7% on the right and in 26.5% on the left. 3) The inferior thyroid artery arose from the thyrocervical trunk in 93.9% on the right and in 84.8% on the left. The inferior thyroid artery was found to be absent in 2 cases (6.1%) on the right and in 5 cases (15.2%) on the left. 4) The thyroid ima artery was found in 15.2%. It arose from the brachiocephalic trunk in 4 cases and from the right common carotid artery in 1 case. (4) In the 3 anomalous types C, G and CG, the arterial distribution to the thyroid gland was as follows; 1) Type C was found in a 8-month-old fetus. The superior thyroid artery originated from the external carotid artery. The right inferior thyroid artery was absent and the left inferior thyroid artery was derived from the thyrocervical trunk. The thyroid ima artery branched from the brachiocephalic trunk. 2) Type G was found in a 7-month-old fetus. The superior thyroid artery originated from the external carotid artery. The inferior thyroid artery arose from the thyrocervical trunk. The thyroid ima artery branched from the right common carotid artery. 3) Type CG was found in a 8-month-old fetus.(ABSTRACT TRUNCATED AT 400 WORDS)

Aorta, Thoracic↗

Secretion of a bone resorbing factor by chick thyroid glands in organ culture.

The ability of the thyroid gland to secrete a bone resorbing factor in vitro was studied using glands obtained from 20-day-old chick embryos. The glands were incubated in a modified BGJ medium containing 1 mg/ml bovine serum albumin under 5% CO2-40% O2 at 37 C. The culture media were assayed in vitro by measuring the stimulation of the release of previously incorporated 45Ca from cultured 19-day fetal rat bone shafts over a 48 h period. The glands secreted a stimulator of bone resorption which did not appear to be parathyroid hormone (PTH). The dose-response curve for the thyroid gland factor was not parallel to that obtained using PTH and secretion was not under calcium control. Neither thyroxine (T4) nor triiodothyronine (T3) produced a marked stimulation of bone resorption over a wide range of doses. Bone resorption stimulated by the thyroid gland factor was inhibited by calcitonin (CT). Concentrations of TH and thyroid gland factor which were minimally effective when tested separately, produced a marked synergistic response when added together. This synergism was not seen when T4, T3, PGE1, or PGE2 were tested with PTH. Media obtained by culturing explants of embryonic chick liver, heart and muscle did not have bone resorbing activity. Secretion of the bone resorbing factor by thyroid glands was blocked by Indomethacin (10(-5)M) but the effects of the factor on bone were not blocked by this agent. These results suggest that the thyroid gland is capable of secreting a stimulator of bone resorption, possibly a prostaglandin, which is capable of synergizing with PTH, and which may represent a tissue factor which under certain circumstances may exert an influence on bone.

Animals↗

Protein metabolism in hypo- and hyperstimulated rat thyroid glands. I. Protein synthesis of different thyroidal proteins.

The comparative study of the in vivo synthesis of thyroglobulin and proteins other than thyroglobulin was carried out in thyroid glands from animals submitted to different levels of TSH stimulation. The different levels of hormonal stimulation modify neither the rate of labeling after injection of the isotope, nor the level of the free labeled amino acid in the glands (percent of the total uptake), but they have a very significant effect on the level of incorporation of the isotope into total proteins. In hypostimulated thyroids the total protein synthesis is very much reduced, while in hyperstimulated glands it is significantly increased. In both hyper- and hypostimulated animals, the proportion of radioactivity bound to the particulate protein fraction is higher than in control rats. However, the solubilization by digitonine of these proteins is lower in hypostimulated and higher in hyperstimulated animals than in controls. Thyroglobulin synthesis is significantly modified qualitatively and quantitatively in both hypo- and hyperstimulated glands. Qualitative modifications are characterized by a changed ratio of 19 S/12 S molecules with respect to the controls. This is probably caused by a more important dissociation of 19S molecules, due to the lower level of halogenation in both hypo- and MTU treated glands. The quantitative modifications of thyroglobulin synthesis, expressed either in absolute values (DPM/mg of tissue), or relatively to the total proteins (percent of total newly formed proteins), are characterized by a very important inhibition of this synthesis in hypostimulated glands, and its stimulation in glands chronically submitted to the TSH action. The modifications of synthesis observed for the proteins other than thyroglobulin are less significant in both types of treated glands than are those observed for thyroglobulin. The level of hormonal stimulation has no effect on the distribution of these proteins between soluble and the particulate fraction, but seems to have a slight effect on the solubilization of the latter ones. Comparative evaluation of the TSH effect on the synthesis of different thyroidal proteins shows that it has a much more specific and significant action on thyroglobulin than on other proteins. The differential effect of TSH on the synthesis of thyroglobulin and proteins other than thyroglobulin suggests that different mechanisms may exist by which TSH regulates the synthesis of these two types of proteins.

Animals↗

The investigation of galectin-3 in diseases of the thyroid gland.

OBJECTIVE: Malignant tumors of the thyroid gland exhibit a variety of histopathologies and clinical behavior. Immune markers are gaining more and more importance in diagnostic pathology, especially in the differential diagnostics and in the grading of thyroid gland tumors. DESIGN: The Authors investigated the immunohistochemical reaction of galectin-3 (gal3) in patients with various thyroid gland diseases. They tested the diagnostic value of gal3 in determining the benign or malignant nature of various lesions, especially in lesions of follicular origin, because previous results have indicated nearly 100% specificity and sensitivity in this regard. METHODS: Gal3 immunoperoxidase reaction was carried out on 91 sections of thyroid gland samples fixed in formalin and embedded in paraffin. RESULTS: While gal3 expressed itself strongly and diffusely in papillary carcinomas (19 of 20 cases), in other malignant lesions it showed weaker, focal or variable positivity. Focal positivity was found in four of 19 follicular adenomas, and negativity was found in three of 10 follicular carcinomas. In all cases of inflammation a focal positivity was observed (eight of eight cases). All nodular goiter and normal thyroid tIssue were negative (25 of 25 cases). CONCLUSIONS: Based on our results, the gal3 immunohistochemical reaction seems to be reliable in the diagnosis of papillary carcinomas. However, in the case of solitary thyroid nodules and follicular lesions, although it is still a useful supplementary marker, it is not of absolute value (as stated in previous studies) in determining whether a tumor is benign or malignant.

Adenoma↗

Iodinated phospholipids and the in vitro iodination of proteins of dog thyroid gland.

Slices of dog thyroid gland were incubated with liposomes consisting of (125)I-labelled phosphatidylcholine (the iodine was covalently linked to unsaturated fatty acyl chains). The (125)I label of (125)I-labelled liposomes was incorporated into thyroid protein and/or thyroglobulin at a higher rate than was the (131)I label of either Na(131)I or (131)I(2). The iodine was shown to be protein-bound by the co-migration of the labelled iodine with protein under conditions where free iodine, iodide and lipid-bound iodine were removed from protein. The uptake of iodine from the iodinated phospholipid was probably due to phospholipid exchange between the iodinated liposomes and the thyroid cell membrane, since (a) (14)C-labelled phospholipid was metabolized to (14)CO(2) and (b) many lipids in the tissue slice became (14)C-labelled. A very strong inhibition of iodide ;uptake' from Na(131)I, caused by thiosulphate, produced only a minor inhibition of the incorporation of (125)I from (125)I-labelled liposomes into thyroid protein and/or thyroglobulin. This implies that free iodide may not necessarily be formed from the iodinated phospholipids before their entrance or utilization in the cell. Synthetic polytyrosine polypeptide suspensions showed some iodination by (131)I-labelled liposomes. In tissues with low tyrosine contents, such as liver and kidney, only a trace uptake was observed. Salivary gland showed some uptake. Endoplasmic reticulum of thyroid gland showed a higher iodine uptake than that of the corresponding plasma membranes. These experiments, together with the demonstration of the diet-dependent presence of iodinated phospholipids in dog thyroid, leads us to suggest that iodination of the membrane phospholipids of thyroid cells may be directly or indirectly involved at some stage in the synthesis of thyroglobulin, or exists as a scavenger mechanism, to re-utilize and/or recover released iodine from unstable compounds inside the thyroid cell.

Animals↗

[Diagnostics and treatment of the functional autonomy of the thyroid gland].

Functional autonomy of the thyroid gland (FATG) remains an important problem due to iodine deficiency over the whole territory of Russian Federation and the fact that iodine prophylaxis has not been conducted for a long period of time. Since iodine deficiency affects the thyroid gland (TG) as a whole, the formation of nodules is not limited to a single lobe, but leads to the development of multinodular goiter, the main feature of which is morphological and functional heterogeneity of TG tissue. Active cell proliferation in the iodine deficiency related goiter is associated with an elevated risk of somatic mutations, including activating mutations leading to thyrocyte functional autonomy. Diagnosis is often late due to the absence of any specific complaints in most patients. Hence, the pathology is often an accidental finding and is mostly revealed in patients with cardial diseases. For a long time, TG scintigraphy has been the only method allowing the diagnosis of FATG, while other techniques, such as ultrasonography and the measurement of the hormone levels in blood, only make it possible to assume the presence of this pathology. Nowadays, fine needle biopsy plays an important role since it gives a possibility to obtain direct cell-level findings concerning the morphological structure of TG nodules and, in some cases, the functional condition of cells. Of late, great importance to clinical practice has been attached to new developments in FATG diagnostics, immunomorphological (immunocytochemical and immunohistochemical) techniques in particular. Most probably, new techniques of FATG verification will be based upon the study of TSHR as the specific marker of this pathology, and it will be possible to use immunocytochemical assay as an additional diagnostic method for the verification of autonomic nodular formations as early as right after the puncture.

Biopsy↗