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The thyroid cartilage and thyroid gland forming a lump at the suprasternal notch is a surprising congenital anomaly which I believe has not been previously reported. A case with co-existent low hyoid bone, pharyngo-oesophageal junction and intrathoracic cricoid cartilage with no cervical trachea is presented. Its pathogenesis is suggested and its surgical importance is discussed.
Bovine thyroid glands are known to contain a complex array of gandliosides. One of the predominant gangliosides was isolated analyzed by gas-liquid chromatography and mass spectrometry. The carbohydrate composition was fucose, N-acetylneuraminic acid, galactose, N-acetylgalactosamine, and glucose in molar ratios of 1:1:2:1:1. The structure of the ganglioside was identified as: (Formula: see text).
The thyroid glands obtained at autopsy from 60 patients ranging in age from 16 to 89 years were immunostained for calcitonin (CT) by the peroxidase-antiperoxidase procedure. The numbers of CT immunoreactive cells identified were 0.99 +/- 1.07/mm2 in the young patients (16 to 39 years of age), 0.99 +/- 1.46/mm2 in the middle-aged (40 to 59 years of age), and 2.97 +/- 3.69/mm2 in the elderly (60 years of age and older). The results were not statistically significant because of the large standard deviation. The CT immunoreactive cells tended to aggregate in clusters in a pattern similar to that seen in C-cell nodules in older persons.
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One hundred thyroids from autopsies performed in a Cancer Center were sectioned at 4 mm intervals. Each slice was processed to obtain one or several sections for histologic examination. Five primary microcarcinomas and ten secondary clinically unknown carcinomas were found. This study and the review of the literature confirm that the high prevalence rate of microcarcinomas, most of them papillary, in autopsies does not agree with the clinically diagnosed carcinoma rate. Tumors greater than 5 mm in diameter may sometimes be aggressive. Intrathyroid metastases are relatively frequent in cancerous dissemination observed in autopsies, but raise problems when they precede the primary tumor or are revealed on surgical samples a long time after because of a slow development. The authors emphasize the importance of differential diagnosis between primary and secondary tumors and the value of immunohistochemistry for histological diagnosis.
Autoimmune thyroiditis (EAT) can be induced by immunizing mice against mouse thyroglobulin. A gene critical to the phenotypical expression of EAT was mapped to the H-2K locus by studying B6 mice and its mutant strain B6.H-2ba. To identify organs in which expression of the gene was decisive for the EAT phenotype, we transplanted thyroid or irradiated thymus glands into various strains of normal mice or thymusless nude mice. We found that the pathophysiology of EAT was controlled by the expression of specific H-2 genes in both the target thyroid gland and the thymus gland.
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A total of 293 patients with chronic autoimmune thyroiditis were observed. The circulating antibody titre to thyroglobulin was determined and 131I-radioindication of the thyroid gland was made in 65 patients. The mentioned studies were diagnostically informative in the complex examination of patients with chronic autoimmune thyroiditis.
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Thyroid gland volume, ultrasonically determined, and thyroid function were investigated in 40 patients with chronic renal failure (33 of these on hemodialysis) and 40 sex-, age- and weight-matched healthy controls. None had thyroid autoantibodies or a clinically detectable goiter. The median thyroid gland volume was significantly elevated in the uremic patients: 24 ml (range 8-43 ml) compared with the healthy controls 17 ml (range 10-22 ml) (p less than 0.005). The serum concentrations of thyroxine (T4), triiodothyronine (T3), free thyroxine index (FT4I) and free triiodothyronine index (FT3I) were significantly decreased in uremic subjects compared with the controls. The serum concentration of thyrotropin did not differ significantly between patients and controls. None of the thyroid function variables correlated with thyroid gland volume. In conclusion, thyroid gland volume was increased in patients with chronic renal failure. The alterations in thyroid hormone concentrations could, however, not explain this finding.
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Reported herein is a rare case of malignant T-cell lymphoma of the thyroid gland that developed in a 71-year-old woman with a past history of chronic thyroiditis. The chief complaints were rapidly growing neck mass, weight loss and hoarseness. Presence of abnormal lymphoid cells in the peripheral blood, and an increase in anti-microsome antibodies and anti-thyroglobulin antibodies were found on preoperative laboratory tests. A diagnosis of suspicious malignant lymphoma of the thyroid gland accompanied by Hashimoto's thyroiditis was made, and a total thyroidectomy was performed. Histological examination revealed diffuse small lymphocytic infiltration in the thyroid gland associated with Hashimoto's thyroiditis. Immunohistochemical examination showed that the small lymphocytes were positive for T-cell markers with CD4 predominance. Southern blot analysis of tumor specimens revealed a monoclonal T-cell receptor gene rearrangement. Peripheral T-cell lymphoma was diagnosed. No adjuvant therapy was performed because of the tumor stage and its subtype. The patient is well with no recurrence or metastasis 25 months after the surgical removal of the thyroid. The present case suggests that Hashimoto's thyroiditis might play an important role in the carcinogenesis of thyroid lymphoma not only of B-cell lineage but also of T-cell lineage.