This 80-year-old white female's death came as the result of cardiopulmonary disease -- hypertension, coronary artery disease, pulmonary emphysemaPulmonary emphysema is a condition in which the air spaces distal to the terminal bronchioles are permanently increased in size due to either destruction of the wall or alveolar dilatation. and cardiac hypertrophy.
During a routine postmortem examination, this patient's thyroid gland was found to be nodularNodular hyperplasia of the prostate--characterized by large discrete prostatic nodules--is a common disorder in men over 50 years of age. The nodules cause the prostate to be enlarged and to have an increased weight. The human prostate is surrounded by a restrictive capsule. These nodules cause increased pressure within the capsule which leads to constriction of the urethra as it passes through the prostate. Urethral constriction leads to retention of urine.. The right lobe contained several colloid nodules. Located in the left lobe was a 2-cm well-circumscribed mass.
This is a higher-power view of the border between the tumor mass and the adjacent thyroid tissue. Note that the mass has compressed the adjacent normal thyroid tissue (arrow). Also note the different morphology between the adenoma (very cellular, dense follicles, little or no colloid) and the adjacent normal thyroid (larger follicles, colloid).
- What is the likelihood that this tumor would have been 'hot' or would have taken up radioactive iodine?
Benign tumors are more likely to take up radioactive iodine than malignant tumors.
Goiter, adenomas, neoplastic tumors of the thyroid.
- Although usually asymptomatic, what important clinical problems can occur in patients with benign thyroid adenomas?
- increase in size and cause pressure symptoms in the neck,
- achieve a certain size and then plateau,
- suddenly enlarge and become painful owing to intralesional hemorrhage, and
- rarely synthesize T3 or T4 and cause hyperthyroidism that is usually mild and unassociated with ophthalmopathy.
No. The risk of malignant transformation is almost negligible.
- eMedicine Medical Library: Evaluation of Solitary Thyroid Nodule
- eMedicine Medical Library: Thyroid Nodule
- Tonacchera M, Vitti P, Agretti P, Ceccarini G, Perri A, Cavaliere R, Mazzi B, Naccarato AG, Viacava P, Miccoli P, Pinchera A, Chiovato L. Functioning and nonfunctioning thyroid adenomas involve different molecular pathogenetic mechanisms. J Clin Endocrinol Metab 1999 Nov;84(11):4155-8.