Visualization of the thymus with therapeutic doses of radioiodine in patients with thyroid cancer

Michigishi, Takatoshi; Mizukami, Yuji; Shuke, Noriyuki; Yokoyama, Keitaro; Noguchi, Masakuni; Watanabe, Y; Matsui, Osamu; Aburano, Tamio; Tonami, Norihisa; Hisada, Kinichi

doi:10.1007/bf02261249

Cited by 48 publications

(39 citation statements)

References 7 publications

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“…This patient, who was reported on by Alibazoglu et al, 20 was a woman age 54 years with a Hü rthle cell carcinoma (high-risk) who also had histologically proven retrolaryngeal metastases, which probably increased her serum Tg level significantly. In a patient described by Michigishi et al, 19 a 19-year-old female with Tg antibodies, the thymus was removed but did not contain metastatic thyroid tissue; this patient also underwent therapeutic neck dissection for metastatic papillary thyroid carcinoma. Reports from the literature 3-6,16 -20,24 -26 illustrate that our protocol can be useful in the treatment of patients with DTC and 131 I uptake in the mediastinum after initial adequate surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

Implications of mediastinal uptake of ¹³¹I with regard to surgery in patients with differentiated thyroid carcinoma

Haveman

Phan

Links

et al. 2004

Cancer

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BACKGROUNDFindings of mediastinal uptake of 131I after surgical treatment for differentiated thyroid carcinoma (DTC) are common, especially in young patients. Given the frequency of false‐positive findings, a protocol for diagnostic and therapeutic strategies would be useful. With the goal of accurately selecting management strategies, the authors analyzed their data and data found elsewhere in the literature for correlations with the incidence of mediastinal 131I uptake and with treatment for patients exhibiting such 131I uptake.METHODSAll patients with DTC who were treated between 1978 and 2000 at Groningen University Hospital (Groningen, The Netherlands) and who received adjuvant 131I ablation therapy were included in the current analysis, which involved retrospective review of all relevant data.RESULTSFive hundred four patients with DTC initially underwent total thyroidectomy, with additional 131I ablation performed for 489 of these patients. In 48 of 489 patients (9.8%), 131I uptake was seen in the mediastinum on a posttreatment scan. Analysis of those 48 patients and of cases in the literature demonstrated that serum thyroglobulin levels, risk status, and the presence of thymus on radiologic images were important in the surgical decision‐making process.CONCLUSIONSMediastinal uptake of 131I on posttreatment scans was found in approximately 10% of patients after total thyroidectomy for DTC. Based on the current data and the data presented in the literature, the authors developed a flow chart for determining appropriate treatment strategies, which included mediastinal dissection for high‐risk patients and for patients with serum thyroglobulin levels > 10 ng/mL. Cancer 2005. © 2004 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Implications of mediastinal uptake of ¹³¹I with regard to surgery in patients with differentiated thyroid carcinoma

Haveman

Phan

Links

et al. 2004

Cancer

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“…However, in most of the cases, the uptake of radioiodine occurs because of the presence of a residual normal thymus (20)(21)(22)(23)25) or thymic hyperplasia (8,18,19,24).…”

Section: Discussionmentioning

confidence: 99%

“…(23) -symporter (hNIS) by an extra thyroidal tissue, including the thymus, but with a capability of transport and concentration of iodine smaller than that presented in the thyroid gland. These findings could explain why the majority of cases found in the literature of thymic iodine uptake occur more commonly on the post-therapy scans, when higher activities are administered, or during an evaluation some time after the ablation of the thyroid remnant, when there is more radioiodine to be taken up by the thymus (2,18,19,31).…”

Section: Discussionmentioning

confidence: 99%

“…An uncommon cause of false-positive WBS is iodine uptake by the normal thymus, which may be misinterpreted as thyroid metastases to mediastinal nodes or to the lung (18)(19)(20)(21)(22)(23)(24)(25). It is very important to recognize this condition and its characteristics in order to facilitate the differentiation between this normal variant and the presence of metastases.…”

Section: Introductionmentioning

confidence: 99%

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Radioiodine concentration by the thymus in differentiated thyroid carcinoma: report of five cases

Mello

Flamini

Corbo

et al. 2009

Arq Bras Endocrinol Metab

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The radioactive iodine has been used with great value as a diagnostic and therapeutic method in patients with differentiated thyroid carcinoma previously submitted to total thyroidectomy. False-positive whole-body scans may occur due to misinterpretation of the physiologic distribution of the radioisotope or lack of knowledge on the existence of other pathologies that could eventually present radioiodine uptake. Thymic uptake is an uncommon cause of false-positive whole-body scan, and the mechanism through which it occurs is not completely understood. The present paper reports five cases of patients with differentiated thyroid cancer who presented a mediastinum uptake of radioiodine in a whole-body scan during follow-up. The patients had either histological or radiological confirmation of the presence of residual thymus gland. It is very important to know about the possibility of iodine uptake by the thymus in order to avoid unnecessary treatment, such as surgery or radioiodine therapy. Arq Bras Endocrinol Metab. 2009;53(7):874-9. KeywordsThyroid neoplasms; thyroid gland; thymus gland; iodine isotopes; radionuclide imaging resumo O iodo radioativo tem sido utilizado com grande valia como método diagnóstico e terapêutico em pacientes com carcinoma diferenciado de tireoide previamente submetidos à tireoidectomia total. Resultados falso-positivos na pesquisa de corpo inteiro (PCI) podem ocorrer por má interpretação da distribuição fisiológica do radioisótopo ou por não conhecimento da existên-cia de outras patologias que podem eventualmente captar o radioiodo. Captação pelo timo é uma causa incomum de resultado falso-positivo e o mecanismo pelo qual ocorre não é totalmente esclarecido. O presente trabalho relata cinco casos que apresentaram PCI positiva em mediastino durante o seguimento, com comprovação histológica ou tomográfica sugestiva de timo. Ressalta-se a importância do conhecimento dessa possível causa de falso-positivo a fim de se evitar tratamentos desnecessários. Arq Bras Endocrinol Metab. 2009;53(7):874-9.

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“…Thus, normal thymic cells are able to trap iodine. Several cases have then been reported describing thymic uptake of radioiodine in patients treated for thyroid cancer [8][9][10][11][12]. More recently, Davidson J. and McDougall R. reported seven instances of activity in the mediastinum visualised by whole body scan (WBS) among 175 patients.…”

Section: Introductionmentioning

confidence: 99%

Mediastinal Images Resembling Thymus Following 131-I Treatment for Thyroid Cancer

Montella¹,

Caraglia

Abbruzzese

et al. 2005

Monaldi Arch Chest Dis

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The follow-up of Differentiated Thyroid Cancer conventionally includes serum thyroglobulin and periodic Whole Body Scans. The uptake of 131-I in normal and pathological tissues different from metastatic thyroid cancer sites is a cause of false-positive scans. Among them, mediastinal uptake caused by thymic hyperplasia can be observed. The aim of the present study was to review a series of 573 patients with differentiated thyroid cancer treated with 131-I after surgery between 1992 and 2003 looking above all for those with mediastinal images resembling thymus. This evaluation is presented together with some hypotheses on the relationships between thymus and thyroid. Moreover, some considerations are made on the differential diagnosis between thymus and mediastinal tumour thyroid residues.

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Visualization of the thymus with therapeutic doses of radioiodine in patients with thyroid cancer

Cited by 48 publications

References 7 publications

Implications of mediastinal uptake of ¹³¹I with regard to surgery in patients with differentiated thyroid carcinoma

Implications of mediastinal uptake of ¹³¹I with regard to surgery in patients with differentiated thyroid carcinoma

Radioiodine concentration by the thymus in differentiated thyroid carcinoma: report of five cases

Mediastinal Images Resembling Thymus Following 131-I Treatment for Thyroid Cancer

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Visualization of the thymus with therapeutic doses of radioiodine in patients with thyroid cancer

Cited by 48 publications

References 7 publications

Implications of mediastinal uptake of 131I with regard to surgery in patients with differentiated thyroid carcinoma

Implications of mediastinal uptake of 131I with regard to surgery in patients with differentiated thyroid carcinoma

Radioiodine concentration by the thymus in differentiated thyroid carcinoma: report of five cases

Mediastinal Images Resembling Thymus Following 131-I Treatment for Thyroid Cancer

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Implications of mediastinal uptake of ¹³¹I with regard to surgery in patients with differentiated thyroid carcinoma

Implications of mediastinal uptake of ¹³¹I with regard to surgery in patients with differentiated thyroid carcinoma