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PubMed2001

Solitary fibrous tumour of the thyroid gland.

Solitary fibrous tumours of the thyroid gland are rare; only five cases have been reported in the literature. Clinically, they present as a long-standing firm mass in the thyroid. Histologically, they show a range of appearances including so-called 'patternless growth pattern', spindle-cell morphology, alternating hypo- and hyper-cellular areas, keloid-like hyalinization and a prominent haemangiopericytoma - like architecture. The behaviour of extrathoracic solitary fibrous tumours is unpredictable and requires careful, long-term follow-up.

Humans↗
PubMed1997

125I uptake competing with iodine absorption by the thyroid gland following povidone-iodine skin application.

Povidone-iodine solution is widely used to disinfect the skin surface or prevent suppuration during human and animal surgery. Using radioisotope 125I, we examined whether iodine may be absorbed and then concentrated in the thyroid gland when povidone-iodine solution is applied to the skin of rats or mice. The competition for 125I uptake was examined in mice and rats after the application of povidone iodine to the skin. We also traced the process of absorbed 125I in the thyroid glad during the fixation for tissue preparations. Povidone-iodine applied to the skin significantly reduced the uptake of 125I both in mice and rats. Significant flux of 125I from the thyroid gland in povidone-iodine treated animals was noted during the thyroid fixation of tissue preparations. From these results, povidone-iodine application to the skin instead of stable KI administration may be practical for preventing the uptake of 125I by the thyroid gland during 125I compound administration for medical therapy. In animal experiments concerning thyroid functions, careful attention must be paid when povidone-iodine is used for disinfection in animal surgery.

Administration, Cutaneous↗
PubMed1975

Iodine-induced thyrotoxicosis in apparently normal thyroid glands.

Although iodine-induced thyrotoxicosis was reported to occur in patients with obvious underlying thyroid disorders, it is not known to occur in patients with apparently normal thyroid glands. From ten such cases evidence is presented that thyrotoxicosis: a) appeared during treatments by iodide or organic-iodine-containing drugs, in the absence of any past history of thyroid disorder; b) was accompanied by almost undetectable radioidine uptake which nevertheless could be activated by TSH; c) subsided spontaneously within a few weeks or months after stopping the high intake of iodine; d) and left, after a period of hypothyroidism, an apparently normal thyroid gland which had resumed normal size, function, uptake, and suppressibility.

Adult↗
PubMed2004

[Retrospective analysis of the results of surgical treatment of 407 patients with differential thyroid gland cancer over a period of 23 years].

Over a period of 23 years (1980-2002) 407 cases of differential thyroid gland cancer were operated, monitored and analyzed at the Endocrine Surgery Clinic of Alexandrovska University Hospital. Of them 71.7% were monitored over a period of more than 10 years (up to 23 years), and 39.3% were monitored between 15 and 23 years. The youngest patient was 12 years old, and the oldest--78 years old. All patients were at a T(1-3) N(a-b) M0 stage. 308 (75.7%) patients had papillary carcinoma, and multi-centric localization was established in 3.9%, while capsular invasion and unilateral lymph-nodular metastases--in 6.2% of those patients. Follicular cancer was found in 24%, and vascular invasion--in 15.1%. 72.4% of the patients fall within the low-risk age groups (women under 50 years of age and men under 40). The treatment of 22.1% (90) of the patients comprised thyroidectomy with a follow-on 131J therapy. 77.9% (317) of the patients underwent radical thyroid gland resections of various size. Bilateral subtotal resections were applied most often--in 64.5% of all cases, and the rest of the patients underwent lobectomy with contra-lateral subtotal resection. The recurrence rate among the patients treated with radical resections is 6.1%, mainly within the high-risk age group. No correlation was established between the recurrence rate and the type of organ-saving surgery. In the group of patients treated with thyroidectomy and 131J, recurrences of the disease were established in 16.2%, again mainly within the high-risk age group. Remote metastases and mortality were established in 3% and 2.5% respectively. In conclusion, preference is given to organ-saving surgical treatment of differential thyroid gland cancer, and it is recommended that in the high-risk age groups the operations be of a broader scope.

Adenocarcinoma, Follicular↗
PubMed1978

Immunohistochemical localization of thyroid hormone in rat thyroid gland.

Direct and indirect immunofluorescence techniques were used to localize the thyroid hormones triidothyronine (T3) and thyroxine (T4) in adult rat thyroid gland. Optimum dilutions of the antisera were established and four tissue fixatives were investigated for usefulness in this technique. Use of antibodies specific for either T3 or T4 resulted in brilliant fluorescence in the colloid pools and apical cytoplasm of follicular cells. In all cases, the adjacent parathyroid gland was devoid of fluorescence. This report demonstrates that these dipeptide hormones can be localized by using immunofluorescence techniques.

Animals↗
PubMed1984

[Sonography of the thyroid gland. Volume determination and morphologic correlation of echo and tissue structures].

The volume of 15 autopsied thyroid glands was determined by fluid displacement and compared with their sonographically obtained stereometric volumes. Maximum variation was 8.6%. Thyroid volumes were measured by ultrasound in 100 volunteers between ages 15 and 36. Total mean value was 19.8 ml. with a mean value of 22.1 ml. in the male group and 17.8 ml. in the female group. 20 volunteers had an additional scintigraphic examination. The thyroid volumes estimated by scintiscanning differed up to 85% with the volume measurements from sonography. Sonography scans were obtained from 6 autopsied thyroid glands and compared with the corresponding tissue slices. Tissue structures were reproduced with great accuracy by ultrasound.

Adolescent↗
PubMed1982

Somatostatin immunoreactive C cells in thyroid glands from various mammalian species.

The relative distribution of somatostatin- and calcitonin-containing cells in thyroid glands from various mammalian species was investigated by immunoperoxidase staining, and the concentration of immunoreactive somatostatin by radioimmunoassay. In the thyroid glands of guinea pigs and rabbits, most of the calcitonin cells were also immunoreactive to the somatostatin antiserum, and high concentration of immunoreactive somatostatin was obtained. On the other hand, in the thyroids of other animal species--rats, dogs, pigs, cows, goats, cats, monkeys, mice, and hamsters--only a few C cells revealed the immunoreaction for somatostatin, and the concentration of somatostatin was low. In all animal species studied, the somatostatin was present in the same cells that contain calcitonin, though in guinea pigs and rats there were some C cells containing a large number of reaction products for somatostatin but very few for calcitonin. Thus, it was concluded that there was a considerable variation in somatostatin immunoreactivity of thyroid C cells from species to species.

Animals↗
PubMed1991

Urinary iodine and the state of the thyroid gland in Czech children.

In 1988 the authors examined by palpation a total of 978 13--14-year-old children (490 boys and 488 girls) from two areas with a different endemic incidence of goitre (Sedlcany area high endemic, Príbram area low endemic). By palpation in this group a non-palpable thyroid gland was found in 48.2% boys and 33.2% girls. Type 1A in 44.9% boys and 50.0% girls, type 1B in 6.5% boys and 14.8% girls and type 2 in 0.3% boys and 2.0% girls. From this basic group by random selection a representative group of 200 children was selected where the following were assessed: urinary iodine/g creatinine, T3, T4, TSH and the volume of the thyroid gland. Urinary iodine in children from the Sedlcany area: boys 74.98 +/- 52.57 micrograms I/g cr, girls 75.36 +/- 77.05 micrograms I/g cr, children from the Príbram area: boys 55.0 +/- 23.36, girls 58.0 +/- 30.24 micrograms I/g cr. The difference between urinary iodine in boys from the two areas is significant (P < 0.05). The prevalence of optimal urinary iodine (i.e. 101-150 micrograms I/g cr) was in the Sedlcany area 6--13%, in the Príbram area 2.5-8.0% (girls, boys). The difference between areas was not significant. Volume of the thyroid gland in the Sedlcany area: boys 7.20 +/- 2.26 ml, girls 8.0 +/- 2.66 ml, in the Príbram area: boys 7.18 +/- 3.01 ml, girls 7.79 +/- 2.63 ml. The prevalence of children with a volume of the thyroid gland above 10 ml in the Sedlcany area was 20% in boys and 21.6% in girls. In the Príbram area 18.4% in boys and 17.5% in girls. The difference between areas was not significant. T3 in the Sedlcany area in boys: 2.43 +/- 0.53, in girls 2.42 +/- 0.51 nmol/l, in the Príbram area in boys 2.61 +/- 0.50, in girls 2.53 +/- 0.62 nmol. The difference between areas is not significant. T4 in the Sedlcany area in boys: 132.3 +/- 26.39 nmol/l, in girls: 132.92 +/- 26.77 nmol/l, in the Príbram area in boys: 126.7 +/- 23.89 nmol/l, in girls 147.8 +/- 40.2 nmol/l. The difference is significant in girls (P < 0.05). TSH Sedlcany area in boys: 1.62 +/- 0.67 mU/l, in girls 2.07 +/- 0.72 mU/l in the Príbram area in boys: 1.77 +/- 0.95 mU/l, in girls 2.10 +/- 1.25 mU/l. The difference is not significant. The prevalence of elevated T3 levels (above 3.0 nmol/l) in the Sedlcany area was 7.4% in boys and 8.9% in girls, in the Príbram area 15.4% in boys and 14.0% in girls. The difference is not significant.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1990

Carcinoma of the thyroid gland in Auckland, New Zealand.

We have reviewed the Auckland experience (1969 to 1987) of 212 instances of carcinoma of the thyroid gland. Females outnumbered males by 4:1, the average age of the patients was 46 years and differentiated cancer was more common (180) than either anaplastic (20) or medullary carcinoma (12). The incidence was higher in the Polynesian patients, most of whom were born outside of New Zealand, than in Maori or European patients, most of whom were born in New Zealand. Patients with papillary carcinoma fared well with greater than 90 per cent of the patients alive at the time of the study, while the corresponding figure for follicular carcinoma was 70 per cent. For both types of differentiated carcinoma of the thyroid gland, the best results, in terms of outcome and morbidity, occurred after total ipsilateral lobectomy and partial contralateral lobectomy (TL + CLPL). In neither type of operation was the use of an adjuvant radioiodine therapy of any obvious benefit. The incidence of permanent complications was twice as high after total thyroidectomy than for TL + CLPL. In contrast with the situation regarding adjuvant radioiodine, patients who presented with systemic follicular carcinomatosis responded well to therapeutic radioiodine, and if thyroidectomy could also be accomplished, the outcome was good. Most patients with anaplastic carcinoma presented with unresectable disease and no regimen used made any impact on the biologic factors of the disease. All but one of the patients with medullary carcinoma had the sporadic variant, and the results were similar after performing either unilateral operation or total thyroidectomy. Carcinoma of the thyroid is more common in Polynesians born in Pacific Islands than in Caucasians or Maoris born in New Zealand. For differentiated carcinoma of the thyroid gland, a satisfactory combination of outcome and morbidity is accomplished with TL + CLPL. Although therapeutic radioiodine is effective in patients with metastatic differentiated carcinoma of the thyroid, we could not show that surgical treatment plus adjuvant radioiodine yielded better results than surgical treatment alone. The major prognostic factors governing the outcome were the histologic type (most patients with papillary carcinoma survive; most patients with anaplastic carcinoma die irrespective of treatment, and patients with follicular and medullary lesions have an in-between outlook) and the presence of systemic disease. The presence of regional disease did not appear to influence the outcome.(ABSTRACT TRUNCATED AT 400 WORDS)

Carcinoma↗
PubMed2003

Image texture analysis of sonograms in chronic inflammations of thyroid gland.

The current practice in assessing sonographic findings of chronic inflamed thyroid tissue is mainly qualitative, based just on a physician's experience. This study shows that inflamed and healthy tissues can be differentiated by automatic texture analysis of B-mode sonographic images. Feature selection is the most important part of this procedure. We employed two selection schemes for finding recognition-optimal features: one based on compactness and separability and the other based on classification error. The full feature set included Muzzolini's spatial features and Haralick's co-occurrence features. These features were selected on a set of 2430 sonograms of 81 subjects, and the classifier performance was evaluated on a test set of 540 sonograms of 18 independent subjects. A classification success rate of 100% was achieved with as few as one optimal feature among the 129 texture characteristics tested. Both selection schemes agreed on the best features. The results were confirmed on the independent test set. The stability of the results with respect to sonograph setting, thyroid gland segmentation and scanning direction was tested.

Algorithms↗
PubMed1988

[Scintigram after TSH in blocked thyroid gland].

The wellknown principle of the overcoming of an iodination blockade of the thyroid gland by TSH-stimulation is diagnostically effective in the thyroid gland blocked by iodine or medicaments. The up to now not suitable method gains importance in an increasing number of blocked scintigrams within the framework of the prophylaxis of struma with iodide/iodate. Exact indications are shown. As secondary findings the investigation shows an increase of the cases of hyperthyroidism in temporary connection with the iodine prophylaxis.

Adenoma↗
PubMed1994

Bcl-2 protein expression in carcinomas originating from the follicular epithelium of the thyroid gland.

The bcl-2 product has been related to the block of programmed cell death (apoptosis) both in lymphoid and in epithelial cells. The pathological expression of bcl-2 has been investigated mainly in haematological malignancies. Here we have investigated bcl-2 expression in a model of epithelial tumours represented by the spectrum of carcinomas arising from the follicular epithelium of the human thyroid gland. The analysis was carried out by immunocytochemistry on archival material using monoclonal antibodies against bcl-2 and thyroglobulin (Tg) on consecutive sections of 94 well-differentiated carcinomas (WDCs), 19 poorly differentiated carcinomas (PDCs), and 22 undifferentiated carcinomas (UCs) of the thyroid gland. In a subset of 5 cases of UC showing a differentiated component (UC-D), the expression of p53 protein was also investigated. As controls, fetal and adult normal thyroid glands and adenomas were analysed. bcl-2 expression was detected in 74 of 94 cases (78.7 per cent) of WDC, 16 of 19 cases (84.2 per cent) of PDC, and 3 of 22 cases (13.6 per cent) of UC. Simultaneous expression of bcl-2 protein and Tg was observed in 74 of 94 cases (78.7 per cent) of WDC, 13 of 19 cases (68.4 per cent) of PDC, and in no case of UC. bcl-2 and Tg immunostaining was detected in all fetal and normal thyroid glands as well as in the adenoma specimens examined. In the subset of UC-D, mutual exclusion of bcl-2 and p53 expression was observed in the undifferentiated and differentiated components (p53 but not bcl-2 expressed in the former).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed2000

A case of sarcoidosis and sarcoid granuloma, papillary carcinoma, and Graves' disease in the thyroid gland.

Sarcoidosis is a systemic chronic granulomatous disease of unknown etiology most commonly affecting young females. The disease was first described in the thyroid gland in 1938. Our patient, a 27-year-old male with known sarcoidosis, was referred to the National University Hospital for acute symptoms of thyrotoxicosis (weight loss of 6 kg, tremor, thyroid enlargement, and tachycardia). Laboratory findings showed suppressed serum thyrotropin (TSH, <0.03 mU/L [0.5-4.20]), increased total thyroxine (T4) (223 nmol/L, [60-140]), and triiodothyronine (T3) (8.5 nmol/L, [1.5-2.7]). Furthermore, Tc-99m pertechnetate scintigraphy disclosed diffuse accumulation of the isotope confirming the diagnosis of Graves' disease. During the next 18 months of antithyroid treatment (thiamazole, Thycapzol) hyperthyroidism was difficult to control, the thyroid gland gradually enlarged, and surgery was recommended. Initially, the patient declined surgery but after an additional 18 months, he accepted surgery. During the 36-month period of antithyroid drug treatment TSH was suppressed (<0.01 mU/L) and T3 often elevated despite high doses of thiamazole. Total thyroidectomy was performed, and histologic examination of the removed thyroid tissue confirmed the diagnosis of Graves' disease and also the presence of sarcoid granuloma and metastatic papillary adenocarcinoma with spread to neck lymph nodes. Four months later, a modified radical neck dissection was performed with removal of neck lymph nodes followed by external radiation therapy (2 Gy x 32 fractions to the neck). The concomitant presence of sarcoidosis, papillary carcinoma, and Graves' disease in a thyroid gland, to our knowledge, has not previously been described in the literature.

Adult↗
PubMed2006

Importance of routine evaluation of the thyroid gland prior to open partial laryngectomy.

OBJECTIVES: To determine the incidence and presentation of synchronous thyroid lesions in a patient population undergoing open partial laryngectomy (OPL), and to determine whether routine preoperative evaluation of the thyroid gland prior to OPL is useful to identify synchronous thyroid lesions in order to reduce the need for reoperation in this complex patient population. DESIGN: Retrospective medical chart review. SETTING: Academic institution. PATIENTS: Sixty-seven consecutive patients with laryngeal tumors who had undergone OPL from 1996 to 2005. INTERVENTIONS: Charts of 67 consecutive patients with laryngeal tumors who underwent OPL in 1996 to 2005 have been reviewed for synchronous thyroid lesions. For all patients, reports of (1) complete preoperative examination findings, (2) inpatient course, (3) postoperative follow-up, and (4) postoperative final histopathologic findings were reviewed. For patients with synchronous thyroid lesions, reports of (1) thyroid evaluation and imaging and (2) preoperative (fine-needle aspiration), (3) intraoperative (frozen section), and (4) postoperative (final) histopathologic results for the thyroid lesions were reviewed. MAIN OUTCOME MEASURES: Incidence of synchronous thyroid lesions and laryngeal cancer in patients undergoing OPL. RESULTS: Eight (11.9%) of 67 (95% confidence interval, 5.3%-22.2%) patients with laryngeal tumors who underwent OPL had evidence of synchronous thyroid lesions. All 8 patients had squamous cell carcinoma of the larynx and underwent either supracricoid or supraglottic laryngectomy. In these 8 patients, synchronous thyroid lesions were incidentally detected. Four patients had papillary thyroid carcinoma, 1 had squamous metaplasia, and 3 had follicular thyroid tissue that was negative for malignancy on final pathologic examination. In 2 patients, the thyroid lesions were detected preoperatively (prior to OPL); in another 2 patients, thyroid masses were detected intraoperatively; and in 4 patients, the thyroid disease was identified postoperatively on histopathologic examination of excised cervical lymph nodes. In 2 patients, thyroidectomy was performed as a second operation after the OPL, and 1 of them had transient vocal fold paralysis for 2 months. Thyroid ultrasonography was performed in 4 patients. In 3 patients, the ultrasonography was performed after the OPL final pathologic findings indicated the presence of metastatic thyroid disease in cervical lymph nodes. Ultrasonography revealed intrathyroidal lesions in all 3 patients. CONCLUSIONS: Patients with laryngeal tumors who will be undergoing OPL might have occult synchronous thyroid lesions. Thyroid surgery in patients with previous OPL may have an increased potential for complication owing to postsurgical changes in the central neck region. Routine preoperative evaluation of the thyroid gland, especially with ultrasonography, to screen for occult synchronous thyroid lesions is recommended for all patients with laryngeal tumors who will be undergoing OPL. Eradication of any thyroid cancer detected preoperatively by fine-needle aspiration should be performed at the same time as OPL. Pros and cons of total thyroidectomy for indeterminate thyroid nodules should be discussed with this patient population.

Adult↗
PubMed1991

Observer variation in the clinical assessment of the thyroid gland.

In order to evaluate the reliability of clinical assessment of the thyroid gland, two specialists in endocrinology and two younger doctors independently examined 53 patients twice, and assessed whether they had a diffuse goitre, a multinodular goitre, a solitary nodule or a normal gland. In 30% of the patients all four observers were in agreement, whereas in 47% and 23% of the patients, two and three different diagnoses were given, respectively. Inter-observer variation was determined and kappa values between -0.04 and 0.54 were found. Intra-observer variation was smaller, revealing kappa values between 0.44 and 1.00. The present study suggests that clinical assessment of the thyroid gland may lead to misclassification of the type of thyroid disease, and thereby to a less than optimal choice of therapy.

Adult↗
PubMed1986

Hurthle cell carcinoma of the thyroid gland. A tumor of moderate malignancy.

Hurthle cell carcinoma is a rare thyroid cancer histologically related to the well-differentiated malignancies of the thyroid gland. This report presents the evaluation of 30 years experience in treating 17 patients (out of 549 thyroid cancer patients) with Hurthle cell carcinoma. All 17 patients were treated surgically. Six patients (35.3%) died of their thyroid disease. Survival rates for 10 and 15 years were 63.7% and 25%, respectively. These rates are above those of high-grade malignancies and below those of low-grade malignancies of the thyroid gland. Nonsurgical treatment, including radioactive iodine therapy, is disappointing; thus, initial radical surgery is recommended as the treatment of choice.

Adolescent↗