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PubMedDate not supplied

[A combination of thyroid diseases with a neoplastic process in the thyroid tissue].

Altogether 252 case records of patients operated on for thyroid cancer were analyzed to determine the frequency of combination of a neoplastic process with autoimmune thyroiditis. Analysis of morphological findings of the operative material has shown that thyroid cancer in autoimmune thyroiditis occurs 2.5-times less than in adenomatous goiter and 1.5-times less in diffuse toxic goiter. The resultant conclusion is that the combination of thyroid cancer with autoimmune thyroiditis occurs more seldom than cancer with diffuse toxic goiter and adenomatous goiter, and the combination of autoimmune thyroiditis with diffuse toxic goiter and adenomatous goiter occurs more frequently than that with thyroid cancer.

Adult↗

PubMedDate not supplied

[Thyroid antibodies in autoimmune diseases of the thyroid and their dependence on the presence of autoantigens].

Autoimmune thyroid diseases (especially diffuse toxic goiter) are characterized by a higher frequency of the detection and concentration of serum thyroglobulin. The frequency of the detection of antibodies to thyroglobulin in Hashimoto's thyroiditis was higher and their concentration lower than in diffuse toxic goiter. The frequency of the detection of antibodies to microsomal thyroid antigen in autoimmune thyroid diseases was lower than that of antibodies to thyroglobulin and did not depend on a type of disease. In diffuse toxic goiter the level of antibodies to thyroglobulin showed positive correlation with the level of antibodies to microsomal antigen and negative correlation with serum thyroglobulin concentration. In Hashimoto's thyroiditis the level of antibodies to thyroglobulin correlated with the level of serum thyrotropin. One-six years after thyroid extirpation serum thyroglobulin was practically absent in patients with Hashimoto's thyroiditis, and the frequency of the detection of thyroid autoantibodies (especially antimicrosomal ones) was sharply decreased.

Adolescent↗

PubMedDate not supplied

Immunohistochemistry of thyroid hormones as a functional parameter in thyroid pathology.

The authors study by means of immunoperoxidase method the pattern of thyroglobulin, triiodothyronine and thyroxine distribution in 58 cases of thyroid disorders: 15 euthyroid goiters, 10 Graves' disease, 7 Hashimoto's thyroiditis, 11 folliculo-papillary carcinomas (6 primary tumors and 5 lymph node metastases), 8 follicular carcinomas, 4 anaplastic carcinomas and 3 medullary carcinomas. Thyroglobulin, triiodothyronine and thyroxine were present in most of the thyroid disorders, excepting anaplastic and medullary carcinomas. Thyroglobulin and thyroxine were localized both in the follicular epithelium and in the colloid, whereas triiodothyronine was present especially in the follicular cells. The thyroid hormones distribution in benign lesions is rather similar. In carcinomas, the pattern of thyroglobulin, triiodothyronine and thyroxine is more heterogeneous, but generally the triiodothyronine distribution is similar to that of thyroglobulin. In some carcinomas, triiodothyronine and thyroxine showed a weak or negative immunostaining. The immunoperoxidase method is a valuable tool in the study of functional disturbances in the thyroid pathology and in the diagnosis of thyroid carcinoma metastases as well. Positive thyroid hormones staining clearly indicates the thyroid origin of metastases.

Histocytochemistry↗

PubMed1985

The incidence of thyroid carcinoma in patients with Hashimoto's thyroiditis and solitary cold nodules.

The reported incidence of thyroid carcinoma in Hashimoto's thyroiditis varies widely. For this reason the specific subpopulation of patients with Hashimoto's thyroiditis and a solitary cold nodule was analyzed. Between 1972 and 1984 we operated on 146 consecutive patients with solitary cold nodules and Hashimoto's thyroiditis. There were 47 carcinomas, for an incidence of 32%. The mean age of the 146 patients was 43 1/2 years (median 44 years), with 126 females and 20 males. There was a history of prior head and neck radiation exposure in 54 patients, with a 33% incidence of thyroid carcinoma. The 92 patients without a history of radiation exposure had a 31.5% incidence of carcinoma. The frequency of multicentricity (bilateralism) was 33% in the group that underwent radiation and 24% in the group that did not. To date, with a mean follow-up of 4.7 years, there have been no deaths and no evidence of recurrence. In conclusion, we report a 32% incidence of thyroid carcinoma in patients with Hashimoto's thyroiditis and a solitary cold nodule, with no apparent difference between the patients with or without a history of radiation exposure, although there was a higher incidence of bilateralism (33% versus 24%) in the carcinomas of the patients with a history of head and neck irradiation. We suggest that the operative management of these patients is total thyroidectomy for those with a history of head and neck radiation and thyroid lobectomy for patients with no history of radiation, followed by contralateral lobectomy if a carcinoma is demonstrated.

Adenocarcinoma↗

PubMedDate not supplied

[Silent thyroiditis and postpartum thyroiditis].

OBJECTIVE: Six cases of silent thyroiditis are described. Clinical, analytical, therapeutical and prognostical features are reviewed. DESIGN: Descriptive and retrospective study. SETTING: Outpatient endocrinological clinic of a General Hospital PATIENTS OR OTHER PARTICIPANTS: Six women (age 26-41 years) that fulfil clinical and analytical criteria of silent thyroiditis. In 4 patients thyroiditis was diagnosed in the postpartum period and in the remaining 2 there was no relationship with pregnancy. MAIN MEASUREMENTS AND RESULTS: Serum levels of thyroid hormones and thyroglobulin and thyroid peroxidase antibodies were measured in all patients. Follow-up period was between 12 and 41 months. The 2 patients with the sporadic form of silent thyroiditis showed clinical and analytical data of thyrotoxicosis that spontaneously resolved. The remaining 4 patients presented with hypothyroidism. In one of them the hypothyroidism spontaneously resolved, in 2 it became permanent and in a further one it developed to subclinical hypothyroidism. CONCLUSIONS: Silent thyroiditis (sporadic or postpartum) is a frequent disorder, usually benign and transient. It can present in different clinic forms and evolve to resolution of permanent thyroid dysfunction.

Adult↗

PubMed1997

Effectiveness of the thyroid scan in evaluation of the solitary thyroid nodule.

Solitary, palpable thyroid nodules are common, but only a small percentage are malignant. It is important to evaluate these nodules in a cost-efficient manner that avoids missing a cancer. Historically, radioisotope imaging has played a major role in the workup of thyroid nodules; however, with the advent of fine needle aspiration biopsy (FNAB), this role has become less clear. From 1974 to 1994, 770 patients with a solitary nodule underwent thyroidectomy. Preoperatively, 471 had thyroid scans, and 149 had FNAB. The incidence of carcinoma in nodules excised on the basis of thyroid scan was 23 per cent, whereas the incidence of carcinoma was 37 per cent when FNAB was used (P = 0.003). Fine needle aspiration was a significantly better predictor of malignancy than thyroid scan and resulted in a smaller proportion of excisions for benign nodules. Thyroid scan provided little additional information in those patients who underwent FNAB. Because thyroid scans add little in determining which nodules require surgical excision, they should no longer be a routine part of the evaluation of a solitary thyroid nodule.

Adolescent↗

PubMed1997

Transgenic mice bearing a human mutant thyroid hormone beta 1 receptor manifest thyroid function anomalies, weight reduction, and hyperactivity.

BACKGROUND: Resistance to thyroid hormone (RTH) is a syndrome characterized by refractoriness of the pituitary and/or peripheral tissues to the action of thyroid hormone. Mutations in the thyroid hormone receptor beta (TR beta) gene result in TR beta 1 mutants that mediate the clinical phenotype by interfering with transcription of thyroid hormone-regulated genes via a dominant negative effect. In this study, we developed transgenic mice harboring PV, a potent dominant negative human mutant TR beta 1 devoid of thyroid hormone binding and transcriptional activation, as an animal model to understand the molecular basis of this human disease. MATERIALS AND METHODS: Standard molecular biology approaches were used to obtain a cDNA fragment containing mutant PV which was injected into the pronucleus of fertilized egg. Founders were identified by Southern analysis and the expression of PV in tissues was determined by RNA and immunohistochemistry. Thyroid function was determined by radioimmunoassays of the hormones and the behavior of mice was observed using standard methods. RESULTS: The expression of mutant PV was directed by the beta-actin promoter. Mutant PV mRNA was detected in all tissues of transgenic mice, but the levels varied with tissues and with different lines of founders. Thyroid function tests in transgenic mice with high expression of mutant PV showed a significantly (approximately 1.5-fold) higher mean serum total of L-thyroxine levels (p < 0.01) than those of nontransgenic mice. Moreover, thyroid-stimulating hormone levels were not significantly different from those of nontransgenic mice. In addition, these mice displayed decreased weights and a behavioral phenotype characterized by hyperactivity. CONCLUSIONS: These mice have phenotypic features consistent with the commonly observed clinical features of RTH and could be used as a model system to better understand the action of mutant TR beta 1 in a physiological context, which could lead to better treatment for this disease.

Animals↗

PubMed2006