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[The effect of nonthyroidal diseases on the serum hormone level of the thyroid gland function regulation cycle].

Thyroid hormone serum concentrations were measured in clinically apparently euthyroid patients suffering from diseases that have symptoms in common with thyroid dysfunction. The diseases investigated were: anorexia nervosa (n = 13), myocardial infarction (n = 13) cirrhosis of the liver (n = 19), terminal renal insufficiency (n = 30) and rheumatoid arthritis (n = 14). In each group, the patients were divided into groups according to the degree of their disease. A relative decrease in 3,5,3'-triiodothyronine (TT3) serum levels is the most pronounced effect of all the non-thyroidal ailments investigated. Individual observations show that total and free thyroxine levels can also be lowered by some acute illnesses. Moreover, the extent of the decrease in TT3 serum levels depends significantly on the severity of the non-thyroidal illness. This phenomenon was observed in all ailments investigated. Based on our findings it is concluded that the diagnosis of thyroid dysfunction may be extremely difficult in many non-thyroidal illnesses. This study should help the clinician to evaluate laboratory hormone data correctly in respect to the diagnosis of thyroid dysfunction in patients with non-thyroidal illnesses.

Adolescent↗

[Tissue of ultimobranchial origin in normal and pathologically altered thyroid gland].

Heterogeneity of the thyroid parenchyma and the sources of development of its main components are considered. The least studied are components originating from the ultimobranchial body to which "the second" system of the ultimobranchial follicles and solid epithelial cell nests belong. The data on the incidence, topography and age dynamics of these nests are presented. Their histochemical and immunocytochemical characteristics are given. Hypothesis on a possible role of solid cell nests as a source of various cell types in the thyroid as well as on their probable participation in the genesis of mixed thyroid tumours is discussed.

Animals↗

[The significance of certain histologic parameters in the differentiation and diagnosis of Hürthle cell adenoma and carcinoma of the thyroid gland].

Hürthle cell tumors of the thyroid gland are rare. Their natural history remains incompletely understood what results in their different classification and therapy. The differentiation of benign from malignant Hürthle cell tumors is possible with classical, traditional histologic methods. Authors have analysed 53 patients with Hürthle cell tumor of the thyroid gland which were diagnostically evaluated and treated at the Central Institute for Tumors and Allied Diseases in Zagreb from 1975 to 1988.

Adenoma↗

Nuclear DNA content of the tall cell variant of papillary carcinoma of the thyroid gland.

Tall cell carcinoma of the thyroid gland is an aggressive variant of papillary carcinoma. A high nuclear DNA content has been associated with aggressive clinical behavior and an unfavorable prognosis in several malignant human tumors. It was also described in differentiated thyroid carcinoma. Therefore, analysis of the nuclear DNA content may yield information predictive of aggressive behavior. Accordingly, the DNA content of the tall cell variant was measured and compared with that of the usual form of papillary carcinoma by flow cytometry. Although all the aneuploid tumors were in the tall cell variant group, the difference in nuclear content was not statistically significant. We conclude that differences in the clinical behavior of these neoplasms are not related to alterations in DNA ploidy.

Aneuploidy↗

Some morphological changes in the rat thyroid gland during experimental hyperphenylalaninemia.

BACKGROUND: Little is known about the effect of phenylketonuria on the thyroid gland. In the present study, this problem was investigated by using a defined experimental model of hyperphenylalaninemia (HPA). METHODS: The experimental group was subjected to an HPA regimen (Matsuo and Hommes, 1988. Neurochem. Res., 13:867-870) from the 5th day of postnatal development. The pups were decapitated on the 7th, 14th, 21st, 28th, and 35th days. The thyroid glands were fixed in Bouin's fluid and routinely embedded in paraffin. The staining techniques used were Mallory-Slinchenko's method, toluidin blue, silver impregnation of the basement membrane, immunohistochemical staining of the proliferating cell nuclear antigen (PCNA), and neuron-specific enolase (NSE). RESULTS: The size of the follicles was less than that in the control group. There were no substantial changes in the epitheliomer structures. In almost all of the treated groups, a reduction in the number of PCNA+, NSE+, and mast cells was observed until the 28th day. On the 28th day of HPA, the level of mast cell degranulation was higher (61%) than that in the control group. On the 35th day, these parameters began to reach normal levels. From the 28th day, degenerative changes in the thyroid glands of treated animals were observed in the NSE+ cells. CONCLUSIONS: The HPA condition mainly has an influence on the number and structure of the NSE+ cells of the thyroid gland. One may assume that under HPA the increase in mast cell degranulation plays a significant role in the normalisation of the parameter of the thyroid gland.

Animals↗

[Thyroid gland and carcinoma of the hypopharyngeal-laryngeal region].

The thyroid gland harbours many diseases which require a surgical treatment; the gland may also be involved by some secondary malignant neoplasms. Such type of involvement by laryngeal and hypopharyngeal cancers is more often due to direct extension rather than metastases. In this paper the Authors report their experience of tumoral involvement of the thyroid gland in 35 patients with laryngeal or hypopharyngeal cancer observed from 1986 to 1990. All patients had an epidermoid carcinoma of the larynx or hypopharynx that required an hemithyroidectomy (always plus isthmectomy) or an isthmectomy associated to laryngectomy. On pathologic examination 5 thyroid specimens revealed tumoral involvement in patients with laryngeal neoplasms: 1 case of solitary metastasis and 4 cases of direct extension. In patients with hypopharyngeal lesions, on the contrary, the gland was, in all cases, undamaged. For this very interesting and uncommon finding the Authors agree with Harrison's proposal suggesting total thyroidectomy is necessary in case of subglottic lesions while in all the other laryngeal and hypopharyngeal lesions the homolateral lobe of the thyroid gland and the isthmus should be removed with the specimen also performing a frozen section examination of the contralateral lobe. In this study tumoral involvement of the thyroid gland appeared to be a very important negative prognostic factor and was higher in the subglottic and anterior commissure lesions.

Aged↗

[Extracorporeal biological perfusion of isolated canine thyroid glands].

A model of extracorporeal biological perfusion of the isolated thyroid gland in dogs has been developed. The experiments on dogs were performed to analyse the functional state of the perfused gland. It has been shown that the functional state parameters in 6-hour perfusion were comparable to the control values. It is concluded that the model suggested creates physiologic conditions and can be employed as a model for studying the influence of various factors on the isolated thyroid gland, as well as for investigating problems related to thyroid gland transplantation.

Animals↗

Cytofluorimetric measurements on the DNA contents of tumor cells in human thyroid gland.

The relative DNA contents of thyroid cell nuclei were measured in surgically removed thyroid tissue of 50 patients by means of cytofluorimetry. Smears were prepared immediately after removal of the thyroid nodules according to the classical Feulgen technique. The fluorescence intensities were always compared with those of healthy thyroid tissue prepared in the same way. In each case samples were investigated by the usual histology. The observations indicate that differentiated carcinomas of thyroid gland have an increased DNA content of nuclei, at about the tetraploid level. Among them the follicular carcinomas (11 cases) showed an even higher DNA content of about 250% of the diploid level. Frequency distribution of the cell pools studied revealed a widely scattered aneuploidization of the malignant tumor cells. The benign adenomas displayed only a moderate increase of nuclear DNA content reaching only about 130% of the diploid value. Among the 22 adenomas classified histologically as of benign character, two cases showed very highly increased and widely scattered DNA contents. These latter two cases might be in process of malignant transformation. DNA cytofluorimetry may contribute to a more safe differential diagnosis of the "follicular neoplasia" of the thyroid gland.

Adenocarcinoma↗

OCT4 expression on a case of poorly differentiated (insular) carcinoma of the thyroid gland and minireview.

Poorly differentiated (insular) carcinoma of the thyroid gland is rare and defined as follicular-cell neoplasms that show limited evidence of structural follicular cell differentiation and occupy both morphologically and behaviourally an intermediate position between differentiated (follicular and papillary carcinomas) and undifferentiated (anaplastic) carcinomas. The authors report a case of a 37-year-old Thai woman who presented with a prolonged left thyroid nodule. Final pathological diagnoses of her mass were poorly differentiated (insular) carcinoma with lymphovascular invasion and nodular goiter. The tumor cell arrangements were nest (insular) and trabecular patterns with some follicular formations. Immunohistochemistry of the tumor cells revealed negative immunostaining for OCT4. Expression of OCT4 gene is involved in the regulation and maintenance of pluripotency of embryonic stem cells, germ cells, and in tumor cells. The authors believe that poorly differentiated (insular) carcinoma of the thyroid gland probably develops from the remnant of thyroid stem cells and is not associated with dedifferentiation (anaplasia or loss of cellular differentiation) from nodular goiter or cells of other thyroid carcinomas. Although there was negative immunostain for OCT4 in the presented case, the authors assumed that the tumor cells behave with an intermediate position between thyroid stem cells and prothyrocytes Also they do not behave with thyroblasts. Additionally, the tumor may be associated with new cellular dedifferentiation. However, there is only one case of immunohistochemistry of OCT4 in poorly differentiated (insular) carcinoma of the thyroid gland. Thus, prognosis of the presented still is mainly correlated with clinical and histological findings. Further research on expression of OCT4 gene on thyroid cancers and other malignant tumors relating to tumorigenic cancer cells (cancer stem cells) may be useful to prognostic evaluation and administration of a new chemotherapy and/or radiotherapy that is specific for tumor-initiating cells.

Adult↗

Sarcoidosis of the thyroid gland associated with hyperthyroidism: review of the literature and report of two peculiar cases.

Sarcoidosis is a systemic disease characterized by non-caseating granulomas that rarely involve the thyroid gland. Thyroid sarcoidosis has seldom been documented, and few cases have so far been described in association with hyperthyroidism. Here, we review the literature on this association, report two patients presenting with hyperthyroidism and histologically-proven sarcoidosis, and discuss related clinical, biochemical, pathological and genetic findings.

Adult↗

Morphometric studies on the development of human thyroid gland in early fetal life.

Histological and morphometric studies were performed on 30 thyroid glands obtained from normal human fetuses. Their crown-rump length (CRL) ranged from 57 to 190 mm, corresponding to the gestational age of 10-20 weeks. The weight of the thyroid gland increased proportionally in relation to CRL, foot length and fetus weight. The first follicles containing PAS-positive colloid were observed in the peripheral part of the thyroid gland of 57 mm CRL fetus. The number of follicles per 1 mm2 of thyroid surface section increased up to 85 mm CRL and thereafter gradually declined for the end of studied period of fetal life. The volumes (in mm3) of thyroid epithelium, colloid and stroma, beginning from 85 mm increased proportionally to the CRL while the height of epithelial cells did not change. The epithelium/colloid ratio decreased notably to 165 mm CRL and thereafter remained constant. Results of the present study suggest that the thyroid gland of human fetus approaches structural maturity in 17.5 week of gestation.

Embryonic and Fetal Development↗

Independent effects of liver disease and chronic alcoholism on thyroid function and size: the possibility of a toxic effect of alcohol on the thyroid gland.

In an autopsy study we found thyroid volume significantly decreased in alcoholics with liver cirrhosis as compared to matched controls: 15 mL (range, 7 to 37 mL) v 25 mL (range, 13 to 90 mL) (P less than .01). At the same time the amount of fibrosis of the thyroid glands was higher in the alcoholics as compared to the matched controls: 20% (range, 6% to 40%) v 12% (range, 6% to 23%) (P less than .01). In order to evaluate the relative importance of alcohol consumption and liver disease on thyroid function and ultrasonically determined size, three groups of patients and matched controls (sex, age, weight, and smoking habits) were investigated: group 1, 18 patients with nonalcoholic liver cirrhosis; group 2, 21 consecutive chronic alcoholics (greater than 100 g of alcohol daily for greater than 5 years) without liver cirrhosis (all had biopsy proven fatty change or normal liver); group 3, 31 nonalcoholic patients with chronic nonhepatic, nonrenal disease. In group 1 median thyroid volume and serum FT4I, FT3I, and TSH levels were unchanged compared with the controls. In group 2 median thyroid volume was 13 mL (range, 9 to 32 mL) compared with 27 mL (range, 12 to 44 mL) in the controls (P less than .005). Serum T3 and FT3I levels were reduced, while T4, FT4I, and TSH levels were unaltered. In group 3 serum T3 and FT3I levels were reduced while serum FT4I and TSH levels and thyroid volume were unaltered compared with the controls. It is suggested that alcohol may have a toxic effect on the thyroid gland independent of the degree of liver damage.

Adult↗

[The function of thyroid gland during the course of pregnancy].

The influence of pregnancy on the function of thyroid gland on the one hand and the influence of dysfunction of this organ on duration of pregnancy on the other is a common and topical problem in medicine. For the study of this correlation, 77 pregnant women have been examined, 45 of which suffered from the thyroid gland dysfunction of different levels. According to the level of iodine excretion acute insufficiency has not been detected among the observed pregnant women; 7 (9%) of them had medium insufficiency and 14 (18%) suffered from moderate lack of iodine. Such patients were treated with iodine preparations only. 24 women (31%) were assigned a combined treatment of hormonal (e.g. L-Thyroxin) and iodine medications. Moreover, they were placed under a dynamic monitoring of endocrinologist and the gynaecologist during the entire period of pregnancy. The research also included a detailed study of age dependence, the sequence of pregnancy, extra genital pathologies and regional spreading. The latter showed that the thyroid gland pathology is the most frequently encountered among the pregnant from Tbilisi and its proximity areas (53%) and from the Western parts of Georgia (22%). The thyroid gland pathology is more frequent among women during repeated pregnancy (35%) as compared to the primigravidae (23%). Our overall data show that the dysfunction of thyroid gland is observed in 58.4% of cases. Every examined woman delivered a healthy baby after a full-term pregnancy.

Adult↗

A clinico-pathological survey of thyroid glands in old age.

A quarter of the thyroid gland obtained at post-mortem examination from a group of elderly inpatients were nodular. There was a significant preponderance of women with goitre, but no relationship to age. The incidence of hyperthyroidism was increased in patients with nodular glands. There was no correlation between the weight of the thyroid gland, the age of the patient and the free-thyroxine index. Histological examination of macroscopically normal glands showed tiny follicles, microscopic colloid nodules and fibrosis. Nodular glands had the features of long-standing colloid nodular goitre. Focal lymphocytic thyroiditis was observed in a fifth of the glands. Microscopic evidence of altered function was common but could not always be correlated with the results of the thyroid function studies.

Aged↗

Scintiscan characteristics of normal thyroid gland in a region of known iodine intake.

Morphological features of a normal thyroid gland in a geographical region where the daily iodine intake is about 1 mg are established. The mean weight of the thyroid gland is 31.3 gm with a range from 19 to 43 gm. Oblique length of the right lobe is 5.0 cm and that of the left lobe 4.8 cm. The surface area of the right and left lobes is 9.7 and 9.1 cm2, respectively. The weight of the thyroid gland calculated on the basis of the scan obtained with 99mTcO4 is quite variable and shows poor correlation (gamma = 0.40) with the weight obtained on the basis of I-131 scan. It is suggested that the criteria of normalcy be established regionally based on iodine intake, and that an isotope of iodine be used in calculating the weight of thyroid gland for dosimetry purposes.

Diet↗