[Surgery of the thyroid gland].
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Humans↗
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Mixed medullary-follicular carcinoma of the thyroid gland: a clinicopathologic variant of medullary thyroid carcinoma.
A rare case of mixed medullary-follicular carcinoma of the thyroid gland, which occurred in a 44-year-old man, is reported. The thyroid tumor was composed of solid nests of polygonal cells, with an admixture of many evenly distributed thyroid follicles that contained colloid. The lymph node metastases were the same composition as the primary, with follicle formations that contained colloid. Immunohistochemically, in both the primary and metastatic lesions, calcitonin and carcinoembryonic antigen were present in the predominant solid areas of medullary carcinoma, whereas thyroglobulin was demonstrated in the follicular structures. At the ultrastructural level, most of the tumor cells contained numerous neurosecretory granules, but some showed follicular cell differentiation. These findings fulfilled the criteria of mixed medullary-follicular carcinoma of the thyroid according to the World Health Organization classification and also suggested dual neuroendocrine and follicular differentiation of this type of thyroid carcinoma. We reviewed the literature on mixed medullary-follicular carcinoma of the thyroid and concluded that it might constitute another clinicopathologic entity different from conventional medullary thyroid carcinoma; it occurs predominantly in younger males and is associated with a more favorable clinical course than the usual medullary thyroid carcinoma.
Adenocarcinoma, Follicular↗
The effect of posterior lobe extract, adrenalin, and pilocarpine on the response of the thyroid gland to the thyreoactivator hormone of the anterior lobe of the hypophysis.
The studies reported here were directed toward ascertaining in a variety of organisms whether or not any of the three lobes of the pituitary gland affected thyroid activity. We documented a thyroid stimulating action of the anterior lobe of the pituitary gland extract that was not shared in by either the intermediate or posterior lobes. Pilocarpine first depressed the stimulating action of the pituitary extract but, after the fifth injection, it accentuated the response of the thyroid gland to the pituitary extract.
Adrenal Medulla↗
Postnatal variations in the number and size of C-cells in the rat thyroid gland.
The heterogeneous distribution of thyroid C-cells has until now hindered an objective evaluation of changes caused by age or experimental stimuli. To overcome this, a rigorous methodology has been designed to detect variations in shape, size, and number of C-cells throughout development. Using this methodology, we have demonstrated that C-cells do not significantly alter their shape with age. However, their volume increases gradually from 472 microns3 in newborn rats to 1653 microns3 in 120-day-old animals. Over the same time period, the mean number of C-cells within the thyroid gland increased 9-fold (from 1.6 x 10(4) to 1.5 x 10(5), and the number of C-cells per unit area decreased (from 6.15 x 10(4)/mm3 to 2.6 x 10(4)/mm3). We conclude that there are marked variations in size, total number, and number of C-cells per unit area in the rat thyroid gland after birth.
Aging↗
[Quantitative determination of echogenicity of diffuse inflammatory thyroid gland diseases].
Grey level was measured in 93 ultrasonic scans of the thyroid gland in order to quantify hypoechogenicity in diffuse inflammatory thyroid disease. Using a modern ultrasound device (256 grey-scale steps and 7.5-MHz parallel scan), grey levels were measured in normal thyroid glands and euthyreotic goiters as well as in thyroiditis or Graves' disease using a programmed setting of the device. Highly significant differences were found between normal thyroid glands and thyroiditis or Graves' disease. Sensitivity of the method was 65% in discriminating Graves' disease and 91% in discriminating thyroiditis; specificity was 95%. The clinical value of the method for follow-up studies in inflammatory diseases of the thyroid gland still has to be established.
Adolescent↗
[Primary osteosarcoma of the thyroid gland].
Primary extraosseous osteosarcoma of the thyroid gland is a very rare tumor with a poor prognosis. Only few cases have been reported in the literature. Metastases of osteosarcoma in the thyroid gland were also found but are very seldom. A primary thyroid tumor with osteosarcomatous differentiation in a 82-year-old man is presented and the histopathological classification, biological features and possible mechanisms of the occurrence of such thyroid tumors are briefly discussed.
Aged↗
[Maternal and infant thyroid gland during pregnancy and in the postpartum period].
A survey is given of the clinically relevant changes in the thyroid hormone balance of the maternal organism. The total concentrations of thyroid hormone may on account of the increased carrier protein level be incorrectly interpreted in the sense of a hyperthyroidism. The latent hormone binding capacity, however, may by mistake indicate a hypothyroidism. For the determination of the functional position, therefore, a statement about the free hormone fraction is necessary. The TRH-test is evident in pregnancy. Beginning with the 12th week of pregnancy the fetal thyroid gland produces thyroid hormones, from the 16th to the 20th week of pregnancy the fetus is autonomous; and the pituitary gland-thyroid gland-axis is able to function nearly from the 20th week of pregnancy. The consequences resulting from this for the therapy of a disease of the thyroid gland of the mother are explained. Due to a massive TSH-flow with the birth typical changes of the hormone levels develop which may be used for the early recognition of the congenital hypothyroidism (TSH-screening). Possibilities of the diagnosis of the prenatal function of the thyroid gland as well as of the therapy of hypothyroidism are discussed.
Amniotic Fluid↗
A rare variant of thyroid gland vascularization.
Usually the thyroid gland obtains its blood via two paired arteries. One pair, the right and left superior thyroid aa., most commonly arises from the external carotid aa. and the second pair, the right and left inferior thyroid aa. commonly arises from the thyrocervical trunk of the subclavian a. In this particular case the right inferior thyroid a. was replaced by an artery branching off the right internal thoracic a.; the left inferior thyroid a. was replaced by an artery branching off the vertebral a. between the transverse process of the second and third cervical vertebrae. This finding might be explained by the suggestion that in the fetus there exists an anastomotic arterial chain ventral to the spinal column consisting of the thyrocervical trunk and the ascending cervical a. which itself is connected to the vertebral a.
Aged↗
[The effect of carbamide feeding over a long period of time on thyroid gland activity in bulls].
In this experiment, 10 fattening bulls were given 0.27-0.42 g/kg body-weight of urea daily for 4 months. The bulls slaughtered after the experiments showed enlarged thyroid glands. These thyroid glands were much larger than the control glands (P = 0.1%). At the end of the experiment the bulls fed with urea weighed, on average, 44 kg more than the control bulls (P = 5%). The histology and electron-microscopy tests revealed that the bulls had hyperplasia of the thyrocytes, grave hydropic and vacuolar degeneration of the thyroid glands, and a considerable decrease in the colloids of the folliculus. The morphological test on the thyroid glands of bulls fed with the aforementioned level of urea daily for a longer period corresponded with the considerable alterations observed when treating bulls with thiouracil by-products. The consequences of urea-rationing for a longer period were tested and the dangers of thyroid-gland alterations were made apparent. Blood samples (120 cases) were taken in the experiment to determine the concentrations of NH3-N, urea and of thyroxine and triiodothyronine (480 pcs), referring to pre-test conditions. The same parameters were determined five times (every 2 months) during the experiment. The parameters received in the tests were, on average and in terms of extreme values as follows: [table: see text] Except for the histological outcome, the blood tests did not show the hypothyreosis of the whole organism.
Animal Feed↗
[Thyroid gland nodules registered at the Endocrinology Department of the Medical Center in Prokuplje].
INTRODUCTION: Thyroid nodules are often found in clinical practice. General population prevalence is about 4%, whereas in women it is over 6%. The basic disorder of cell kinetics of thyroid tumors is inappropriate growth response to corresponding thyroid-stimulating hormone (TSH) concentration. MATERIAL AND METHODS: At the Endocrinology Department of Medical Centre in Prokuplje, during the first year of practice (1997), 430 patients with thyroid gland disease were registered, both male and female belonging to different age groups. Patients were examined in regard to: sex, age, heredity, symptoms. Basic laboratory analyses were done with the aim to establish inflammatory syndromes: sedimentation, leukocytes, differential blood picture, cholesterolemia and fibrinogenemia; hormones of thyroid glands (T3, T4, TSH) with corresponding radioimmunoassay (RIA) technique. In the aim of identifying the nodules in the thyroid gland and perceiving nodular features, an ultrasound examining was done and scintigraphy of thyroid gland if necessary. Scintigraphy was done with radioactive technicium-99 mTc. RESULTS: From the total number of registered patients (430) with thyroid gland disease, nodules were found in 172 glands (40%). The presence of thyroid nodules is more frequent in women (91.3%). The average age of thyroid gland patients is 50.33 years, of which men aged 52 and women aged 50.17. The following risk factors are stated as the most frequent: chronic stress 58.13%, consuming goiter substances 46.51% (cabbage, kale, sulphonamide). Swollen thyroid gland--goiter occurred in 105 cases (61.07%), whereas in 120 patients (69.32%) normal function was registered. In most cases the nodules are solitary 90 (52.32%). In 71.01% of patients cold nodules were found. In 36.04% of patients nodules were 1 to 1.9 cm in size. The greatest number of patients--83 (36.61%) complained of heart disorder as a symptom. 2.9% out of 172 patients with thyroid nodules underwent operation. DISCUSSION: The obtained data mostly coincide with the findings of other authors. Trbojević found thyroid nodules 3 to 4 times more often with women. In this research it is ten times more frequent. Bozović especially pointed out the existence of inflammatory factors, mentioned in this group in 12.97% cases. We can not neglect the hereditary factor either--11.62% which is not clearly defined by other authors [1,2,3]. According to Trbojević, solitary nodules are present in 60% of cases. In this research the number is 52.32%. Cold nodules are found in 71.07% (according to Trbojević 90%). Only 2.9% of patients were operated, which is not enough if we follow all the medical indications. CONCLUSION: Out of the total number of patients (430) with thyroid gland disease, 172 patients (40%) with nodular changes in thyroid glands have been found. Far more frequent (90%) are women aged 51 to 60 years (after menopause). The number of operated patients with thyroid nodules is insufficient.
Adult↗
[Determination of the ratio of membrane-bound and free polyribosomes and of the content of thyroglobulin in these fractions in normal thyroid gland cells and in several types of thyroid diseases].
The ratio of membrane-bound and free polyribosomes in thyroid gland cells was decreased two-fold in nodular euthyroid goiter and five-fold--in Hashimoto thyroiditis; a slight increase in thyroglobulin synthesis in free polyribosomes was noted in goiter. Impairments in transfer of the translation products across membranes of rough endoplasmic reticulum may be one of the causes of deteriorations in thyroglobulin synthesis in goiters.
Animals↗
[Primary lymphoma of the thyroid gland].
Malignant primary lymphoma of the thyroid gland is a rare disease generally occurring women in the 6(th) or 7(th) decade of life. The principal clinical sign is giant goiter rapidly leading to sings of compression, raising the question of differential diagnosis with anaplastic cancer. The radiological findings in our patient were suggestive of malignancy due to the locoregional invasion. Immunohistochemistry study of the surgical specimen was required to reach the definitive diagnosis of thyroid gland primary lymphoma. Diagnosis of malignant primary lymphoma of the thyroid gland made at the stage of extensive locoregional extension compromises prognosis. Our patient died after one session of chemotherapy.
Aged↗
Lesions of the thyroid gland in patients with primary hyperparathyroidism.
To determine the frequency of coexisting thyroid gland lesions, a consecutive series of 30 patients operated upon for primary hyperparathyroidism were studied. Lesions of the thyroid gland were found in 21 (70 per cent) patients. It is known that patients undergoing surgical treatment for a disease of the parathyroid or thyroid gland should be carefully evaluated both preoperatively and intraoperatively for abnormalities in the other gland or glands to recognize coexistent disease and treat it in one single procedure. The results of this study has lead to the appreciation of the value of a scintiscan of the thyroid gland prior to operations upon the parathyroid gland. All of the patients with an abnormal scintiscan had coexisting pathologic findings of the thyroid gland. These results suggest that it is quite helpful in evaluating the thyroid gland prior to parathyroid gland operations.
Adenoma↗
Pleomorphic liposarcoma metastatic to the thyroid gland.
Although carcinoma is rarely metastatic to the thyroid gland, it has an established place in the differential diagnosis of cold nodules on radionuclide thyroid scans in patients with known cancers. A case of metastatic pleomorphic liposarcoma with involvement of the thyroid gland adds to the list of cases of metastases to the thyroid gland. A patient with known metastatic pleomorphic liposarcoma with a palpable thyroid nodule of 2 months' duration had a thyroid scan with 130 MBq (3.5 mCi) Tc-99m pertechnetate. The scan showed a cold nodule occupying most of the right lobe of the thyroid. Cytologic analysis of a fine-needle aspirate from this cold nodule confirmed metastasis from the known primary cancer, pleomorphic liposarcoma. In a patient with a known primary tumor, a nodule in the thyroid gland should be considered a metastatic lesion, regardless of the time since the primary tumor was diagnosed and treated, until proved otherwise.
Biopsy↗
Immunohistochemical characterization of thyroid gland angiomatoid tumors.
The histogenesis of thyroid gland angiomatoid tumors, probably as a primary angiosarcoma, has been a controversy for many years. These tumors may be variants of undifferentiated (anaplastic) carcinomas. We report a thyroid gland angiomatoid carcinoma in a 61-year-old African American male. The tumor had a heterogeneous pattern with both sarcomatous and epithelioid areas. Tumor cells lined some vascular-like spaces and others had intracytoplasmic lumens containing red blood cells. The tumor cells were found to express multiple endothelial (factor VIII-related antigen, CD31, CD34, and Ulex europaeus I lectin) and epithelial (cytokeratin and epithelial membrane antigen) markers as well as thyroglobulin by immunohistochemistry. This rare presentation demonstrates the heterogeneous nature of thyroid gland angiomatoid carcinoma with both epithelial and endothelial differentiation.
Antigens, CD34↗
Glucocorticoid receptor subunit gene expression in thyroid gland and adenomas.
The present study was undertaken to investigate whether the glucocorticoid receptor -alpha (GR-alpha) and -beta (GR-beta) mRNA may be expressed in thyroid gland. Ten normal thyroid gland and 14 follicular adenomas were studied using a real-time fluorescent quantitative RT-PCR (FQ-RT-PCR) method. The results demonstrated that there was a lower expression of GR-alpha mRNA (x10(6) GR-alpha cDNA copies/microg total RNA) in thyroid adenoma (1.27+/-0.26) than that in normal thyroid gland (3.53+/-1.22) (p < 0.001). The expression of GR-beta mRNA was lower in all the thyroid tissues. Of note, there was a significant difference in GR-beta mRNA expression (x10(4) GR-beta cDNA copies/microg total RNA) between thyroid adenoma (80.8+/-13.9) and thyroid gland (1.78+/-0.59) (p < 0.001). The GR-alpha/GR-beta ratios in thyroid adenoma and normal thyroid gland were 1.67+/-0.68 and 207.57+/-84.41 respectively (p < 0.001). These results revealed, for the first time, that both GR-alpha and GR-beta mRNA expression were detectable in both thyroid gland and adenomas tissues. We therefore conclude that down-regulation of GR-alpha and up-regulation of GR-beta mRNA expression may play an important role in the thyroid adenomas.
Adenoma↗
Follicular cells of the thyroid gland require Pax8 gene function.
The thyroid gland develops from two distinct embryonic lineages: follicular cells (which produce thyroxine) and parafollicular C-cells (which produce calcitonin) are of endodermal and neural crest origin, respectively. Little is known about the molecular mechanisms governing the generation of these different cell types. Mice lacking the transcription factor Ttf1 lack both cell types and thus are unable to develop a thyroid gland. By analysis of Pax8-/- mice, we demonstrate that Pax8 is required for the formation of the follicular cells in the thyroid. We present evidence that Pax8 is necessary for providing cues for the differentiation of competent endoderm primordia into thyroxin-producing follicular cells.
Animals↗
[The effect of insufficient iodine intake on the size and function of the thyroid gland].
BACKGROUND: The supply of iodine indisputably affects the function of the thyroid gland. It is not clear, however, as to what extent a moderate iodopenia affects common thyroid parameters. OBJECTIVES, STARTING POINT AND MAIN PURPOSE: The aim of the study is to evaluate the influence of iodopenia (ioduria below 50 micrograms of iodine per litre of urine) on the values of T4, T3, TSH, the ankle-jerk time and sonographically ascertained thyroid gland volume in randomly selected sample of Czech population from 4 regions. METHODS: Ioduria was assessed by means of Sandel-Kolthoff method, total thyroxine, triiodothyronine and thyreotropic hormone by immunoluminiscence method; the volume of the thyroid gland sonographically according to Gutekunst and the ankle-jerk reflex by electromagnetic record method. RESULTS: Iodopenia affects a majority of investigated parameters in dependence on age. T4 is significantly higher in iodopenic adults, T3 is significantly higher in iodopenic children, TSH is significantly higher in iodopenic adults and the ankle-jerk time is prolonged in iodopenic adults. The statistical significance of the effect of iodopenia on the volume of thyroid gland was not proved. CONCLUSION: Iodopenia of a mediate degree affects commonly used parameters of the thyroid gland function in dependence on age and other factors which are to be more precisely analyzed using a larger sample. The statistical significance of the effect of iodopenia on the volume of thyroid gland was not proved. (Tab. 1, Fig. 5, Ref. 13.).
Adult↗