Search citation statements
Paper Sections
Citation Types
Year Published
Publication Types
Relationship
Authors
Journals
OWING to the infrequency with which nodular goitre occurs in children, 3 cases of recurrent ' adenomata ' which have been encountered are presented and their pathological nature, prognosis, and treatment discussed. Owing to the exigencies of war, it is regretted that clinical details are sparse. CASE REPORTSCase I.-A male child born in 1911 was first seen in 1920, at the age of 9. He was brought to the Out-patient Department complaining of a symptomless swelling in the neck which had first been noticed at the age of 6 and had subsequently for the ensuing three years gradually increased in size. He was operated upon in the same year (1920), a nodular goitre being removed by partial thyroidectomy (Mr. Gordon Bryan).The pathological report showed that nodules varied in size and consistency, but some were paler in colour and more solid. The microscopical picture showed the more solid nodules to be composed of diffuse sheets of cells, but always showing a tendency to form acini (Fig. 605). There was a variation in staining properties of the nuclei, but mitoses were infrequent. Neither capsular nor blood-vessel invasion was seen. Other nodules showed large vesicles with a tendency to papillary projections. In the surrounding thyroid tissue were tiny nodules consisting of small acini (Fig. 606). No colloid was seen in the specimen.Almost immediately after the patient's discharge from hospital a reappearance of the swelling in the neck was noticed and thirteen months later he was re-admitted for a further operation ( I~z I ) , more thyroid tissue being removed (Mr. Zachary Cope). Pathological examination gave a picture almost identical with those of the earlier sections (Fig. 607). After this second operation nothing untoward occurred until 1929, when, at the age of 18, he again sought advice for his steadily enlarging thyroid gland. Yet a third thyroid resection was performed by Mr. Gordon Bryan.It has not proved possible since to trace this patient in person, but information from the Registrar-General's office leads us to assume that he is still alive. The pathological report on the tissue removed at the third operation was very similar to that in the first instance. Nodules up to 2.5 cm. in diameter had been removed, the largest of these being cystic, the smaller ones solid ( Fig. 608). Some consisted of acini of varying sizes lined by cubical epithelium (Fig. 609), but others showed the same characteristics as those already described.Case 2.-A male child, born in 1918, was first seen at the age of 13 years in 1931. He then complained of a swelling of the neck which was said to have been present since birth, but which had been increasing markedly during the last few years. He had had no dysphagia and there were no symptoms or signs suggestive of thyrotoxicosis. He was 4 ft. 4 in. in height and weighed only 4 st. He had never lived in a goitrous district, but had had a sister who was operated upon for a swelling of the thyroid ( ? adenoma) when 9 years old. Subsequent to this operation the goitre had recurred and two y...
The AFTN was established as a clinical entity by the 1918 report of Goetsch, correlating cellular mitochondrial content with nodular function, and showing the inverse correlation between AFTN function and extranodular tissue function. Degeneration, common in AFTNs, can preclude development of hyperthyroidism, eliminate hyperthyroidism, or even induce transient spontaneously resolving hyperthyroidism. AFTNs are nearly always benign. Most reports of malignant AFTNs are inadequately documented. Whether AFTNs are toxic can be determined by clinical evaluation, with laboratory confirmation using principally serum T3 assays and TRH testing. Whether warm nodules are AFTNs may be determined by suppression imaging. Nontoxic AFTNs are usually observed. For older patients with borderline high serum T3 levels, blunted responses to TRH, or subnormal responses on supersensitive TSH assays, prophylactic therapy may be prudent. Toxic AFTNs may be treated surgically (patients younger than 40) or with radioactive iodine (older patients). High dose radioactive iodine therapy is preferred because it more consistently ablates AFTN function.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.