Showing papers on "Thyroid neoplasm published in 1986"

The role of fine-needle aspiration biopsy in the rapid diagnosis and management of thyroid neoplasm.

Abstract: This report describes our 5-year experience with fine-needle aspiration (FNA) biopsy of the thyroid in a 560-bed teaching hospital. Three hundred nine FNA biopsies were performed primarily by one endocrinologist and interpreted by several pathologists. Analysis of the data reveals the sensitivity of the procedure is 93%, specificity is 95.1%, and the positive and negative predictive values are 88.9% and 96.5%, respectively. This data confirms the diagnostic accuracy of FNA biopsy. Complications were seen in 6 of 309 cases (1.9%) and were relatively mild. Nearly 75% of the cases in the series were cytologically diagnosed as nonneoplastic. Fine-needle aspiration biopsy identified 19.4% of the cases needing surgery, of which 72% had neoplastic nodules, confirming the selection role of the procedure. The management of thyroid nodules is discussed and a selective review of the FNA literature is presented. The authors believe that our experience rebuts the argument that special referral centers are needed to interpret the cytologic material. Several well trained surgical pathologists can become proficient in interpreting the FNA biopsies without significant loss in accuracy, and thereby render a definite diagnosis in the vast majority of the cases. Accordingly, the authors recommend FNA of the thyroid as the initial diagnostic test in the evaluation of thyroid nodules.

Modifying influence of dehydroepiandrosterone on the development of dihydroxy-di-n-propylnitrosamine-initiated lesions in the thyroid, lung and liver of F344 rats.

Abstract: Following initial treatment of F344 rats with dihydroxy-di-n-propylnitrosamine, exposure to dehydroepiandrosterone (DHEA) administered in the diet at a concentration of 0.6% brought about significant decrease in weight gain, independent of food consumption, and inhibited the development of thyroid tumors and hepatocyte-altered enzyme foci. In addition to inducing a diffuse increase in glucose-6-phosphatase dehydrogenase (G6PD) and gammaglutamyl transpeptidase in the liver. DHEA treatment was associated with development of small numbers of basophilic hepatocellular foci which differed markedly in enzyme phenotype from the clear cell (glycogen storing) lesions predominating in the carcinogen-treated animals maintained on basal diet. The results are consistent with the concept that DHEA-modification of neoplastic development, as reported earlier in a number of different organs and here in the liver and thyroid, may be in some way partly mediated by changed expression of the key enzyme of the pentose phosphate pathway, G6PD, and related metabolic systems. Heterogeneity in the quality of initiated hepatocytes with regard to capacity for inhibition or promotion indicated by the present data point to the existence of more than one pathway to tumour development in the rat liver.

Angiomatoid carcinoma of the thyroid gland: anaplastic carcinoma with follicular and medullary features mimicking angiosarcoma

Abstract: A 79-year-old man with a 28-year history of a substernal goiter had an anaplastic thyroid neoplasm with prominent angiomatoid features develop. Based on the light microscopic appearance of the tumor and the presence of immunocytochemical staining for Factor VIII–related antigen, a diagnosis of angiosarcoma was made. Subsequent immunocytochemical and ultrastructural studies suggested follicular and medullary differentiation without staining for Ulex europeaus I lectin or evidence of Weibel-Palade bodies. Based on these findings, the tumor is interpreted as an anaplastic carcinoma with evidence of mixed follicular and medullary differentiation and extensive intravascular growth producing an angiomatoid appearance. Positivity for Factor VIII–related antigen may be due to nonspecific uptake of antigen-rich serum and platelets by the phagocytic tumor cells. Factor VIII–related antigen immunoreactivity should be interpreted with caution in intravascular neoplasms.

Induction of thyroid tumors in (C57BL/6N x C3H/N)F1 mice by oral administration of 9-3',4',5',6'-tetrachloro-o-carboxy phenyl-6-hydroxy-2,4,5,7-tetraiodo-3-isoxanthone sodium (Food Red 105, rose bengal B).

Abstract: The tumorigenicity of 9-3',4',5',6'-tetrachloro-o-carboxy phenyl-6-hydroxy-2,4,5,7-tetraiodo-3-isoxanthone sodium (CAS: 632-68-8) [also called Food Red 105 (FR 105) or Rose Bengal B], which is widely used for food or cosmetic coloring in Japan, was examined in (C57BL/6N X C3H/N)F1 mice. Animals were divided into 6 groups with 50 mice in each group, and they were given solutions of 0, 0.125, and 0.5% FR 105 in the drinking water starting at 6 weeks of age and ending at 101 weeks. The mean relative thyroid weights in both sexes of mice given 0.125 and 0.5% FR 105 were significantly increased compared to those of controls. Enlarged thyroid glands were composed exclusively of colloid goiters characterized by distended follicles lined with flattened follicular cells. The male mice given 0.5% FR 105 had follicular adenomas in the thyroid gland at an incidence of 22.9%, which was significantly higher than the incidence in controls (P less than .005). Radioactive 131I uptake in colloid goiters was markedly decreased compared to that in intact thyroid glands. The results indicate that FR 105 can induce colloid goiters and thyroid adenomas in a dose-dependent manner.

The Treatment of Thyroid Cancer: The Role of Fine-Needle Aspiration Cytology

Abstract: • A series of 960 fine-needle aspiration biopsies of thyroid lesions are reported. The primary indication is the presence of a solitary thyroid mass. Aspiration biopsy is accomplished using a 23-gauge needle and a commercially available syringe pistol equipped with a 20.0-mL syringe. Sensitivity for the presence of a thyroid neoplasm, specificity for the absence of a thyroid neoplasm, predictive value of a positive diagnosis for a thyroid neoplasm, and diagnostic efficiency are all over 90% in this series. Eight percent of the aspirates were unsatisfactory. Use of fine-needle aspiration biopsy for the diagnosis of thyroid conditions reduces thyroid surgery significantly for nonneoplastic disease. It is cost-effective and essentially free of complications. ( Arch Otolaryngol Head Neck Surg 1986;112:1200-1203)

Androgen-Mediated Development of Irradiation-Induced Thyroid Tumors in Rats: Dependence on Animal Age During Interval of Androgen Replacement in Castrated Males

Abstract: When male Long-Evans rats at age 8 weeks were radiation treated (40 microCi Na131I), thyroid follicular adenomas and carcinomas were observed at age 24 months with a high incidence of 94%. Castration of males prior to irradiation significantly reduced this tumor incidence to 60%. When testosterone (T) was replaced in castrated, irradiated male rats, differentially increased incidences of thyroid tumors occurred, depending on the time interval for hormone replacement. Immediate (age 2-6 mo) or early (age 6-12 mo) T replacement at approximate physiologic levels led to thyroid follicular tumor incidences of 100 and 82%, respectively, whereas intermediate (12-18 mo) or late (18-24 mo) T treatment led to only 70 and 73% incidences, respectively. Continuous T replacement (2-24 mo) in castrated irradiated male rats raised thyroid tumor incidence to 100%. Since elevated thyroid-stimulating hormone (TSH) is a reported requisite for development of radiation-associated thyroid tumors, the effects of T on serum TSH levels were examined. Mean serum TSH values in all irradiated animal groups were significantly elevated above age-matched nonirradiated animals at 6, 12, 18, and 24 months. Serum TSH levels were higher in continuous T-replaced irradiated castrates than in intact, irradiated males, whereas such intact male TSH levels were greater than those for irradiated castrates without T treatment. Interval T replacement in castrated male rats was generally associated with increased serum TSH levels during the treatment interval and with lowered TSH levels after discontinuation of T treatment, particularly in irradiated rats. However, when irradiated, castrated males received late T replacement (age 18-24 mo), there was no elevation of TSH at the end of the treatment interval. Thus an indirect effect of T via early stimulation of TSH may be at least partly responsible for the high incidence of irradiation-induced thyroid tumors in rats.

Enzyme histochemistry and thyroid neoplasia.

Abstract: The authors have examined the enzyme histochemical staining of surgically removed human thyroid tissue in an attempt to identify markers that might be useful in the histopathologic diagnosis of thyroid neoplasms. Fresh thyroid glands and other tissues were fixed in cold (4 degrees C) 4% paraformaldehyde and embedded in glycol methacrylate. Forty-two specimens were studied in thin sections, which gave excellent histologic detail and enzyme preservation. Cytologic detail was similar to that in Papanicolaou-stained smears, with good definition of nuclear inclusions and grooves, particularly in cases of papillary carcinoma. The enzyme histochemical reactions studied were as follows: adenosine triphosphatase, alkaline and acid phosphatases, alpha-naphthyl acetate esterase, and 5'-nucleotidase. Thyroid epithelial cells and the benign neoplasms derived from them were typically positive for 5'-nucleotidase, alpha-naphthyl acetate esterase, and acid phosphatase, and negative for adenosine triphosphatase and alkaline phosphatase. Staining for adenosine triphosphatase was present in papillary and follicular carcinomas and was seen in benign glands only under certain circumstances such as Graves' disease. The adenosine triphosphatase reaction therefore appears to be helpful in distinguishing between benign and malignant neoplasms derived from thyroid epithelium in humans and may be a useful adjunct to routine morphology.

[A so-called atypical adenoma of the thyroid in an endemic struma area].

Abstract: In view of the benign clinical course of the atypical adenoma and the high diagnostic accuracy of our frozen sections we feel that subtotal strumectomy with in toto removal of the adenoma and closely spaced follow-ups constitutes an adequate treatment of this thyroid neoplasm. In our opinion primary lobectomy means unnecessarily exposing a disproportionately high percentage of patients to the higher complication risk of this more radical surgery. From 1977 to 1982 there were 47 cases of atypical adenoma among our patients. The ratio men: women was 1:3.7, the mean age of the patients was 44 years. The patients underwent subtotal strumectomy. In the period under review "atypical adenoma" diagnosed on the basis of frozen sections turned out to be carcinoma in 5 instances. The follow-up period of the 47 patients that underwent surgery ranges from 1 1/2 to 7 years. None of the patients has had tumor regrowth so far.