Hashimoto's thyroiditis has been reported to be associated with many neoplastic and nonneoplastic thyroid pathologies. This retrospective study aims to determine the demographic profile of Hashimoto's thyroiditis in Sri Lankans, document ancillary pathologies in Hashimoto's thyroiditis, and determine whether there is an increased risk of occurrence of malignancies, benign neoplasms, and nonneoplastic benign lesions in Hashimoto's thyroiditis by comparing with thyroids showing multinodular goiters, follicular adenomas, and colloid nodules. The mean age of Hashimoto's thyroiditis is 43.3 years with the majority in the 41 to 60 year age group and a female to male ratio of 10.3 : 1. This study revealed a statistically significant increase of thyroid malignancies in association with Hashimoto's thyroiditis. The association of Papillary carcinoma, Non-Hodgkin's lymphoma, and Hurthle cell adenoma with Hashimoto's thyroiditis was statistically significant.
A n 8-year-old hyperactive boy was admitted to the hospital after having been found to have elevated blood lead levels, ranging from 17.4 to 27.4 µg per deciliter (reference range, <10) over a period of 2 years. An abdominal radiograph revealed large numbers of small, hyperdense foci in the right lower quadrant. The entire family reported that they regularly ate geese that were killed with lead pellets from a shotgun, and the children reported that they had been eating the pellets as part of a game to make them disappear. The patient and his siblings underwent bowel washout. A follow-up radiograph of the patient revealed that pellets were still present in the gastrointestinal tract, in either the cecum or the appendix (Panel A). Laparoscopic appendectomy was performed. The appendix weighed 27.5 g (normal weight, 4 to 5 g), measured 55 mm in length, and had an average external diameter of 7 mm with a wall thickness of 2 mm. A total of 57 lead pellets were recovered from the lumen (Panel B). Microscopical examination of the appendix showed minor changes with a focus of submucosal calcification and fibrosis. No acute inflammation was observed.
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