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PubMed1994

[Malignancy markers in the cytodiagnosis of thyroid nodules. Thyroid peroxidase].

The enzyme thyroid-peroxidase (TPO) possesses in thyroid malignancy an immunological alteration disclosed by an anti-TPO monoclonal antibody termed MoAb47: a negative immunostaining with MoAb47 thus represent a marker of malignancy for thyroid tumors. The present work has been intended to investigate the ability of TPO immunodetection to assist the diagnosis of malignancy in fine-needle aspirates (FNA) of thyroid nodules. The study concerns 300 patients with histologically proven thyroid nodules. The results of TPO immunodetection have been compared to the final histological diagnosis and in 279 cases, to the results of standard cytological analysis. From 248 benign nodules, 215 yielded more than 80% positive cells. All malignant nodules had less than 80% positive cells and most of them less than 40%. According to these results, with 80% positive cells as the threshold between benign and suspicious or malignant results, the sensitivity of the method for the screening of malignancy is 100%, its specificity 86.7% and its overall accuracy 89%.

Antibodies, Monoclonal↗
PubMed1993

[Determination of thyroid peroxidase antibodies in common thyroid pathology. Methodological and clinical approach].

Thyroid peroxidase antibody levels were measured in 409 patients who came to the thyroid pathology consultation of our Institution between September, 1990, and November, 1991, and were compared with a reference population. In the first 231 patients, we compared the results obtained with two commercial kits. The correlation coefficient between both populations of results was assessed to be 0.919. Only one of the kits was selected later ("Immutest anti-TPOR", Henning, Germany) because normal and pathological values overlapped to a lesser extent. In a population of controls (reference population). 4 cases out of 82 (4.8%) had values exceeding 100 U/ml (arbitrary units), this value being regarded as the boundary of normal conditions. Out of the 409 assays made in patients examined during the thyroid pathology consultation, 137 (33.5%) had pathological values ranging from 100 to 5000 U/ml and even more. Peroxidase antibodies are mainly found in patients with primary hypothyroidism (positive in 82% of cases) and graves' hyperthyroidism (positive in 81%). We have also observed the highest levels in these two conditions. In addition, we have demonstrated a group of patients with normal thyroid conditions who were positive for peroxidase antibodies, sometimes in a family with a history of thyroid pathology. These may be at higher risks to develop hypothyroidism in the future than the general population. A TRH test in some subjects and the clinical evolution of these patients lead us to advocating TPO antibody assay for screening on the first consultation. Endocrine surveillance is advisable in case of positive results.

Antibodies↗
PubMed1977

[Determination of the relative iodine concentration in the lumens of thyroid follicles of normal and neotenic Triturus helveticus, and evaluation of the halogen content of the thyroid colloid. Electron microprobe study (author's transl)].

The stable, bound iodine in the thyroid colloid of Triturus helveticus has been studied with the electron microprobe. Some animals show a normal development. Others are accidentally neotenic due to certain ecological conditions. The values of punctate iodine concentrations (CPI) have been computed and expressed in relative units (counts/s). The mean CPI per lumen is very variable from one follicle to another in the same thyroid section. During normal development, the mean CPI per animal is generally higher in metamorphosing individuals than in larvae. During development with neoteny, the mean CPI per animal attains high values if the larval state is maintained in its totality; the CPI decreases in partially metamorphosed animals, but increases again after metamorphosis. The amount of halogen contained in the thyroid colloid has been computed in relative units (colloid iodine pool). Throughout normal development, the pool remains small if the animals have not attained the adult state. In increases considerably in entirely larval neotenic newts, decreases during metamorphosis but increases afterwards. In totally neotenic newts, the thyroid gland receives only a low hypophyseal stimulation and reacts as the thyroid gland of various hypophysectomized Urodeles. Our results pose the problem as to whether TSH regulates the transepithelial iodine flows, which permit the expansion of the colloid iodine pool, when this hormone is secreted at a very low levels.

Animals↗
PubMed1997

Absence of G(s)alpha gene mutations in childhood thyroid tumors after Chernobyl in contrast to sporadic adult thyroid neoplasia.

Heterotrimeric G proteins participate in the signal transduction cascade. Adult thyroid tumors have been shown to harbor specific point mutations in codons 201 and 227 of the G(s)alpha subunit of the adenylate cyclase stimulator. This protein affects the GDP/GTP turnover and finally results in an enhanced activation of G(s) and thus adenylate cyclase. We attempted to find out if G(s)alpha gene mutations were present in thyroid tumors of children from Belarus after the Chernobyl nuclear accident. Paraffin sections of 20 thyroid tumors were used for PCR amplification by oligonucleotide intron primers flanking exons 8 and 9, encompassing codon 201 and 227, respectively. By direct sequencing of the 274-bp amplification product, we did not detect any mutations of the G(s)alpha gene in codon 201 or 227. In contrast to thyroid neoplasia of adults, G(s)alpha gene mutations do not play a role in the development of childhood thyroid tumors after the Chernobyl reactor accident.

Carcinoma, Papillary↗
PubMed1997

[Belgian registry of thyroid cancer. Preliminary epidemiological characteristics revealed by a retrospective study (1988-1995). Belgian Thyroid Cancer Study Group].

The aim of a cancer registry is to study the incidence of cancer in a well-determined population and to allow epidemiological research to the setting up of diagnosis and therapeutic strategies. The Belgian Thyroid Cancer Study Group (BTCSG) was founded in 1990. In the present study we report data collected from 1988 to 1995 in 397 patients with a differentiated (papillary and follicular) thyroid carcinoma living in the french-speaking area of Belgium. The sex ratio female/male is 3.5 and the median ages at the diagnosis, is similar (45 yrs, 12-82) in both sexes. Seven cases of thyroid cancer were registered in young patients less than 18 yrs old. Thyroid carcinoma were associated with multinodular goiter in more than 50% cases. Cancer was bilateral in 17%. Papillary histological type accounts for 84% in our series while its diagnosis was established in 45% at early clinical stages (TO-T1). These observations could probably be related with 1) broader indications and more aggressive options for the surgical removal of diffuse multinodular goiter, 2) more sophisticated pathologic examinations that might have led to the detection of a greater incidence of occult carcinomas, incidentally discovered. Lymph nodes metastases were present at the time of diagnosis in 20%, especially in young patients. The risk for local and/or lateral recurrence or distant metastases is significantly related to the size of the tumor, histologically verified lymph node metastases and the values of the EORTC prognostic index (> or = 50) that additionally takes into account the differentiation of the tumor. Considering our short median follow-up time of 25 months, it is currently too early to define if the controversial attitude about the extent of surgery (total thyroidectomy plus I131 or individualized surgery) can also negatively influence the risk for recurrence. In our series, eight patients died of thyroid cancer.

Adolescent↗
PubMed1998

[Suppressibility of thyroid autonomy in endogenous and additional exogenous TSH suppression in patients with thyroid autonomy].

AIM: The aim of this retrospective study was to examine the effect of an additional exogenous thyroid hormone suppression on the 99m Technetium Thyroid-Uptake (TcTU) in patients with thyroid autonomy and endogenous TSH suppression. METHODS: 21 patients were examined in the years 1992-1996; they had a primary endogenous suppression (end) of the TSH-b and an evaluation of the TcTU. After an additional exogenous suppression (ex) of the thyroid, the first two weeks with 75 micrograms/dl and the following 2 weeks 150 micrograms/d, or depending on the bodyweight 2 micrograms/kg levothyroxin, another evaluation of the TcTU was performed. The whole patients were called group I with a TcTUend of 1.6%-7.4%. The subgroups were selected by thresholds of the TcTUend; group Ia TcTUend > or = 1.6% and < 2.5%, group lb TcTUend > or = 2.5%, group Ic TcTUend > or = 3%. RESULTS: The intraindividual comparison showed a significant decrease of the autonomous "volume" after exogenous suppression with levothyroxin. This is shown by the following values of the TcTU: group I TcTUend = 3.47 +/- 1.65 and TcTUex = 2.91 +/- 1.38, which means a reduction of 20 rel.% (p < or = 0.001); group Ia TcTUend = 2.05 +/- 0.27, TcTUex = 1.85% +/- 0.22, which means 10 rel.% (p < or = 0.001); group Ib TcTUend = 4.18 +/- 1.59, TcTUex = 3.45% +/- 1.34, which means 20 rel.% (p < or = 0.001); group Ic TcTUend = 5.00% +/- 1.43, TcTUex = 4.05% +/- 1.32, which means 20 rel.% (p < or = 0.001). CONCLUSION: Supposing a structural variability of autonomous thyroid tissue with heterogenous TSH receptors our study shows a significant additional exogenous suppression in already endogenous suppressed TSH receptors.

Adult↗
PubMed1983

Latent childhood thyroid carcinoma in diffuse lymphocytic thyroiditis.

Diffuse thyroid enlargement in a child is a rare presenting symptom of thyroid carcinoma. A papillary carcinoma may be hidden in a diffuse lymphocytic thyroiditis and should be carefully searched for during surgery. Furthermore, the finding, in frozen sections, of psammoma bodies in a lymphocytic thyroiditis should raise the suspicion of an occult malignant neoplasm. A case illustrating these diagnostic difficulties in a 5-year-old child is presented.

Carcinoma, Papillary↗
PubMed1986

Thyroid cancer mimicking thyroiditis.

Two patients with thyroid cancer, who presented with clinical and biochemical features of subacute thyroiditis, are reported, Confusion in diagnosis delayed therapy from 3 to 8 months. The relation between thyroiditis and thyroid cancer is discussed.

Adult↗
PubMed1994

Generalized resistance to thyroid hormone: identification of a novel c-erbA beta thyroid hormone receptor variant (Leu450) in a Japanese family and analysis of its secondary structure by the Chou and Fasman method.

Generalized resistance to thyroid hormone (GRTH) is characterized by elevated circulating levels of thyroid hormone in the presence of a eumetabolic state and failure to respond to triiodothyronine. Various point mutations in the c-erbA beta thyroid hormone receptor gene are known to be responsible for different phenotypes of GRTH. We herein report a new c-erbA beta variant in a Japanese family. The variant consisting of a cytosine to adenine base substitution at nucleotide position 1650 altered phenylalanine to leucine in codon 450 in the T3-binding domain of c-erbA beta. This base substitution was found in one allele of the 2 affected members of the family. The in vitro translation products of this mutant c-erbA beta gene demonstrated a significantly reduced T3-binding affinity. The secondary structure of this mutant thyroid hormone receptor predicted by the Chou and Fasman method included a new turn in the alpha helix structure in the T3-binding domain. We also discuss the secondary structures of the previously reported mutant receptors.

Adolescent↗
PubMed2006

The newly developed three-dimensional (3D) and two-dimensional (2D) thyroid ultrasound are strongly correlated, but 2D overestimates thyroid volume in the presence of nodules.

The newly developed three-dimensional (3D) and two-dimensional (2D) thyroid ultrasound (US) were compared in assessing thyroid volume (TV) in 104 patients: 53 had an isolated thyroid nodule, 32 toxic diffuse goiter, 17 non-toxic multinodular goiter, 1 toxic multinodular goiter and 1 a toxic adenoma. A real-time Technos apparatus (Esaote SpA, Italy) with a 7,5 MHz linear transducer was used. The volume of thyroid lobes by 2D was calculated according to the ellipsoid formula. In the same session, TV by 3D US was calculated using a probe tracking system (in vivo ScanNT Esaote 3.4 MedCom. Darmasdt) and software to reconstruct 3D images, directly giving the lobe volume. There was a very good agreement between 2D and 3D, but in 94/208 lobes with nodular lesions 2D showed a 10% systematic overestimation compared to 3D, the percentage error being higher in lobes with lower volumes. A possible explanation for this result is the inadequacy of the ellipsoid formula in forecasting the correct lobe profile in the presence of nodules. This intrinsic defect of 2D US should be taken into account when evaluating TV in patients with nodular goiter.

Adenoma↗
PubMed1995

Infiltrating gamma/delta T-cell receptor-positive lymphocytes in Hashimoto's thyroiditis, Graves' disease and papillary thyroid cancer.

In the present study we have evaluated the expression of different molecular forms of the antigen receptor (TcR) on lymphocytes derived from thyroid tissue of patients with Graves' disease, Hashimoto thyroiditis and papillary cancer both in situ by APAAP technique and on isolated lymphocytes by indirect immunofluorescence. A panel of monoclonal antibodies (mAbs) recognizing alpha/beta and gamma/delta TcR-positive subsets was used. The results showed that the large majority of T-cells in thyroid infiltrates were alpha/beta TcR+, gamma/delta TcR+ ones being very rare or nearly absent, whatever the disease (autoimmune or neoplastic). No difference between gamma/delta TcR+ T-cell subsets (V delta 1+ or V delta 2+) was observed. Thus, neither in autoimmune thyroid diseases nor in papillary cancer gamma/delta TcR+ cells are likely to be a major effector-T cell population.

Adult↗
PubMedDate not supplied

Painless thyroiditis followed by autoimmune disorders of the thyroid. A case report with biopsy.

Painless thyroiditis is a clinical entity of unknown origin. We report a case of a woman first seen with painless thyroiditis, who consequently developed a true hyperthyroidism, then exophthalmos and finally permanent hypothyroidism. The biopsy findings and serum antibodies determinations at the final stage were of Hashimoto's thyroiditis. The case is discussed and the need for a long follow-up after a painless thyroiditis is stressed.

Adult↗
PubMed1991

Thyroid function evaluation by different commercially available free thyroid hormone measurement kits in term pregnant women and their newborns.

Evaluation of thyroid status by measurement of free thyroid hormone concentrations seems particularly helpful in conditions with altered serum binding proteins. In pregnancy, a condition of increased thyroxine binding globulin, serum free thyroxine (FT4) and free triiodothyronine (FT3) concentrations have been reported to be normal, increased or decreased. In the present study we have measured serum total and free thyroid hormone concentrations in pregnant women, their newborns and nonpregnant women. Serum FT4 and FT3 concentrations have been measured with 10 different commercially available kits and the results obtained have been compared. Serum total thyroid hormone concentrations in pregnant women were significantly higher than in their newborns and in nonpregnant women. Maternal serum FT4 concentrations measured with the different kits were always significantly lower than values in nonpregnant women. Furthermore, with one kit, the mean maternal serum FT4 concentration was below the normal range and with many kits, a large number of maternal serum samples had serum FT4 concentrations below the normal range. With all kits, except two, neonatal serum FT4 concentrations were higher than values in their respective mothers and, in general, lower than values in nonpregnant women. Serum FT3 concentrations in nonpregnant women were in the normal range, except with one kit, in which the mean serum FT3 concentration was below the normal range. Serum FT3 concentrations in newborns resulted markedly lower than in parturient and in non pregnant women. With almost all kits, serum FT3 values were below the normal range in many maternal samples. With one kit, maternal serum FT3 concentrations resulted higher than in nonpregnant women, whereas with the other kits serum FT3 concentrations were lower.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2001

[Thyroid scintigraphy and body scanning with 67 Ga in a case of primary thyroid lymphoma].

The case of a 60-year old woman first presented a rapidly growing left cervical mass is presented. The fine needle aspiration-puncture (FNAP) lead to a diagnosis of thyroiditis. Due to the persistence of the symptoms, the FNAP was repeated again but was not conclusive, so that a surgical biopsy was performed. The pathological diagnosis was diffuse large cell primary thyroid lymphoma (PTL). The PTL is a rare entity that accounts for less than 1% of all the Non-Hodgkin's lymphomas. The thyroid scintigraphy showed the existence of a cold nodule in the left thyroid lobule and the 67Ga scan revealed a large abnormal lesion in the mediastinum that extended to the right latero-cervical region. After two chemotherapy courses, the 67Ga scan was normal.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1998

The tender neck: thyroiditis or thyroid abscess?

Following apparent subacute thyroiditis, a 16-year-old girl developed a left thyroid abscess thought to be secondary to steroids and haematogenous spread from a pilonidal abscess. The thyroid suppuration became recurrent and required partial thyroidectomy. Further left-sided abscess formation in the neck prompted a barium swallow which revealed the source of infection to be a sinus tract arising from the left piriform fossa. The patent fourth branchial sinus tract was later excised. All patients with a tender thyroid should have ultrasound-guided fine needle aspiration to establish the diagnosis. If suppuration is confirmed, a barium swallow is advised to exclude a sinus tract from the piriform fossa.

Abscess↗
PubMed2001

Effects of thyroid hormones on cardiac structure: a tissue characterization study in patients with thyroid disorders before and after treatment.

Experimental evidence suggests an involvement of thyroid hormones in myocardial nonmyocyte component growth. We evaluated the possible role of thyroid hormones in myocardial remodeling by ultrasonic tissue characterization (videodensitometry) in 8 hyperthyroid patients, in 10 hypothyroid patients, and in 2 patients with thyroid hormone resistance syndrome (RTH), before, 60, and 120 days after treatment (T0, T60, T120), and in 10 age-matched euthyroids. According to a previously described procedure, the derived collagen volume fraction (dCVF%, an echocardiographic index estimating the collagen content) was predicted from the pixel-level frequency distribution width (broadband, Bb) of the selected echocardiographic images. Thyrotropin (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) were assessed by immunometric method. QT interval dispersion (QTd) on basal electrocardiogram was measured as a marker of dyshomogeneous ventricular repolarization. At T0, Bb and dCVF% were normal in hyperthyroid and euthyroid patients, and slightly increased in RTH patients, whereas significantly higher values were found in hypothyroids. At T60, a significant reduction in Bb was observed in hypothyroids, with nearly normal dCVF% values. This trend was confirmed at T120 with complete normalization of echoreflectivity. No echoreflectivity changes were observed in hyperthyroid and RTH patients during treatment. QTd was significantly increased in hypothyroids at T0, while no significant differences were found among groups at T60 and T120. Because the different videodeonsitometric myocardial properties observed in hypothyroid versus hyperthyroid patients correspond to an increase of dCVF%, this study suggests that thyroid hormones exert an inhibitory effect on myocardial collagen synthesis in humans.

Adult↗
PubMed1994

Resistance to thyroid hormone in subjects from two unrelated families is associated with a point mutation in the thyroid hormone receptor beta gene resulting in the replacement of the normal proline 453 with serine.

Resistance to thyroid hormone (RTH) is a condition of impaired tissue responsiveness to thyroid hormone characterized by elevated free thyroid hormone levels in serum accompanied by nonsuppressed TSH. RTH has been associated with mutations in the thyroid hormone receptor (TR) beta gene. We report studies carried out in 9 members of a family (F94) of Jewish ethnic origin and a single subject of Mexican origin. All subjects fulfilling the criteria of RTH (6 of family F94 and one of family F27) had the same point mutation in the T3-binding domain on one of the two alleles of the TR beta gene. This mutation resulted in the replacement of the normal proline-453 with serine (P453S). Nevertheless, the clinical characteristics of affected members of each of the two families differed as did the severity of hormonal resistance in terms of responses to the administration of L-T3. Genetic studies indicate that the same mutation occurred independently in each of the two families.

Adult↗
PubMed1997

Phenotype differences of resistance to thyroid hormone in two unrelated families with an identical mutation in the thyroid hormone receptor beta gene (R320C).

A new family with resistance to thyroid hormone (RTH) harboring a mutation in the thyroid hormone receptor (TR) beta gene (R320C) is reported. The phenotype of affected members is compared to that of affected members of an unrelated family with an identical mutation in the TR beta gene that occurred independently. In one of the two families higher concentrations of free T4 were required to maintain a normal TSH level in affected subjects and unaffected first degree relatives but not in relatives by marriage. While this finding suggests that genetic background modulated the relative insensitivity to thyroid hormone caused by the mutant TR beta, it is uncertain whether the higher thyroid hormone levels prevented the occurrence of hyperactivity and attention deficit.

Adult↗