Glandular Enlargement

Chest Imaging ◽  
2019 ◽  
pp. 493-497
Author(s):  
Brett W. Carter

Glandular enlargement in the mediastinum is usually due to hyperplasia of thymus in the anterior mediastinum or thyroid enlargement with intramediastinal growth. Thymic enlargement is typically due to rebound hyperplasia associated with chemotherapy, radiation therapy, and stresses. Rebound thymic hyperplasia manifests as diffuse, symmetric enlargement of the thymus. MRI may be helpful in distinguishing thymic hyperplasia from neoplastic involvement of the thymus, as the former lose signal on opposed-phase T1-weighted MR imaging. Thyroid goiters may originate in the neck and migrate into the mediastinum or arise from an ectopic focus of mediastinal thyroid tissue. Goiters manifest as mediastinal masses that are similar in appearance to the thyroid gland, with intrinsic hyperdensity, hyperenhancement, foci of calcification and cystic change.

Author(s):  
Rita Meira Soares Camelo ◽  
José Maria Barros

Abstract Background Ectopic thyroid tissue is a rare embryological aberration described by the occurrence of thyroid tissue at a site other than in its normal pretracheal location. Depending on the time of the disruption during embryogenesis, ectopic thyroid may occur at several positions from the base of the tongue to the thyroglossal duct. Ectopic mediastinal thyroid tissue is normally asymptomatic, but particularly after orthotopic thyroidectomy, it might turn out to be symptomatic. Symptoms are normally due to compression of adjacent structures. Case presentation We present a case of a 66-year-old male submitted to a total thyroidectomy 3 years ago, due to multinodular goiter (pathological results revealed nodular hyperplasia and no evidence of malignancy), under thyroid replacement therapy. Over the last year, he developed hoarseness, choking sensation in the chest, and shortness of breath. Thyroid markers were unremarkable. He was submitted to neck and thoracic computed tomography, magnetic resonance imaging, and radionuclide thyroid scan. Imaging results identified an anterior mediastinum solid lesion. A radionuclide thyroid scan confirmed the diagnosis of ectopic thyroid tissue. The patient refused surgery. Conclusions Ectopic thyroid tissue can occur either as the only detectable thyroid gland tissue or in addition to a normotopic thyroid gland. After a total thyroidectomy, thyroid-stimulating hormone can promote a compensatory volume growth of previously asymptomatic ectopic tissue. This can be particularly diagnosis challenging since ectopic tissue can arise as an ambiguous space-occupying lesion.


1955 ◽  
Vol 18 (4) ◽  
pp. 445 ◽  
Author(s):  
O. Mühlbock

SUMMARY Hypophyseal tumours in mice develop after prolonged treatment with oestrogens, after injection of radioactive iodine in doses which destroy the thyroid tissue and after prolonged treatment with thiouracil-derivatives. The tumours of the hypophysis only occur in certain strains of mice and hence the genetic constitution is of importance. The origin of this difference between strains has hitherto remained completely obscure. The hypophyseal tumours in mice seen following administration of oestrogens and those observed after destruction of the thyroid gland are morphologically similar. They consist of cells staining blue to varying degrees, and they may thus be termed amphophile tumours. The possible mechanism of development of the hypophyseal tumours has been discussed.


1964 ◽  
Vol 45 (3) ◽  
pp. 381-401 ◽  
Author(s):  
G. Hintze ◽  
P. Fortelius ◽  
J. Railo

ABSTRACT A type of subacute thyroiditis occurring epidemically in a factory in Helsinki was observed in 44 cases. In every case the thyroiditis followed an acute infection of the upper respiratory tract. The variation in incidence during one and a half years was in good agreement with that of the acute infection. Since Helsinki is in an endemic goitre region, the fact that the disease was of the migrating type was of great diagnostic importance. In all cases but one, the nodules have persisted. One case of asymptomatic thyroiditis was seen. In the majority of the patients the thyroid gland had been carefully palpated before the thyroiditis occurred, and in all cases the condition was followed up by the same investigator. Special attention was paid to changes in the iodine metabolism, the serum cholesterol, the electrophoretic distribution pattern of the serum proteins, and the circulating thyroid auto-antibodies. In many cases needle biopsy of the thyroid gland was performed. Thyroid function invariably returned to normal with time, although one patient remained in a hypothyroid state for about a year. In no cases were thyroid auto-antibodies found. For the beta-globulin fraction, the electrophoretic distribution pattern of the serum proteins gave values which were still not normalized in any case, and only in two cases was the alpha2-fraction normalized. The needle biopsy, when thyroid tissue was obtained, showed almost the same picture as in endemic goitre, but in some specimens nonspecific inflammatory changes were seen. Prednisolone relieved the symptoms, but did not affect the course of the disease. According to the present observation this type of epidemic thyroiditis would seem to represent a form of nonspecific subacute thyroiditis.


2021 ◽  
pp. 1-8
Author(s):  
Niamh McGrath ◽  
Colin Patrick Hawkes ◽  
Stephanie Ryan ◽  
Philip Mayne ◽  
Nuala Murphy

Scintigraphy using technetium-99m (<sup>99m</sup>Tc) is the gold standard for imaging the thyroid gland in infants with congenital hypothyroidism (CHT) and is the most reliable method of diagnosing an ectopic thyroid gland. One of the limitations of scintigraphy is the possibility that no uptake is detected despite the presence of thyroid tissue, leading to the spurious diagnosis of athyreosis. Thyroid ultrasound is a useful adjunct to detect thyroid tissue in the absence of <sup>99m</sup>Tc uptake. <b><i>Aims:</i></b> We aimed to describe the incidence of sonographically detectable in situ thyroid glands in infants scintigraphically diagnosed with athyreosis using <sup>99m</sup>Tc and to describe the clinical characteristics and natural history in these infants. <b><i>Methods:</i></b> The newborn screening records of all infants diagnosed with CHT between 2007 and 2016 were reviewed. Those diagnosed with CHT and athyreosis confirmed on scintigraphy were invited to attend a thyroid ultrasound. <b><i>Results:</i></b> Of the 488 infants diagnosed with CHT during the study period, 18/73 (24.6%) infants with absent uptake on scintigraphy had thyroid tissue visualised on ultrasound (3 hypoplastic thyroid glands and 15 eutopic glands). The median serum thyroid-stimulating hormone (TSH) concentration at diagnosis was significantly lower than that in infants with confirmed athyreosis (no gland on ultrasound and no uptake on scintigraphy) (74 vs. 270 mU/L), and median free T4 concentration at diagnosis was higher (11.9 vs. 3.9 pmol/L). Six of 10 (60%) infants with no uptake on scintigraphy but a eutopic gland on ultrasound had transient CHT. <b><i>Conclusion:</i></b> Absent uptake on scintigraphy in infants with CHT does not rule out a eutopic gland, especially in infants with less elevated TSH concentrations. Clinically, adding thyroid ultrasound to the diagnostic evaluation of infants who have athyreosis on scintigraphy may avoid committing some infants with presumed athyreosis to lifelong levothyroxine treatment.


2000 ◽  
Vol 8 (1) ◽  
pp. 59-89 ◽  
Author(s):  
Jeremy J. Erasmus ◽  
H. Page McAdams ◽  
Lane F. Donnelly ◽  
Charles E. Spritzer

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Inès Riahi ◽  
Rim Fradi ◽  
Ibtissem Ben Nacef ◽  
Ahlem Blel

Abstract Background Ectopic thyroid is a developmental anomaly of the thyroid gland of embryological origin. Instead of having a pretracheal situation, thyroid tissue is elsewhere, most commonly in the median cervical line along the course of the thyroglossal duct. Lingual thyroid is the most common presentation. Ectopic thyroid tissue in the submandibular region has been rarely reported. Case presentation We report herein a case of a 65-year-old man admitted to our department with a complaint of a painless swelling in the left submandibular region. Conclusions Thyroid gland ectopia should be considered among the differential diagnoses of submandibular swelling. Ectopic thyroid tissue can present with the same pathology affecting the normal thyroid gland such as malignancy and hyperthyroidism.


Radiology ◽  
2003 ◽  
Vol 229 (3) ◽  
pp. 893-901 ◽  
Author(s):  
Nuschin Morakkabati ◽  
Claudia C. Leutner ◽  
Alexandra Schmiedel ◽  
Hans H. Schild ◽  
Christiane Katharina Kuhl

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Lizette Vila Duckworth ◽  
William E. Winter ◽  
Mikhail Vaysberg ◽  
César A. Moran ◽  
Samer Z. Al-Quran

Intrathyroidal parathyroid carcinoma is an exceedingly rare cause of primary hyperparathyroidism. A 51-year-old African American female presented with goiter, hyperparathyroidism, and symptomatic hypercalcemia. Sestamibi scan revealed diffuse activity within an enlarged thyroid gland with uptake in the right thyroid lobe suggestive of hyperfunctioning parathyroid tissue. The patient underwent thyroidectomy and parathyroidectomy. At exploration, a 2.0 cm nodule in the usual location of the right inferior parathyroid was sent for intraoperative frozen consultation, which revealed only ectopic thyroid tissue. No parathyroid glands were identified grossly on the external aspect of the thyroid. Interestingly, postoperative parathyroid hormone levels normalized after removal of the thyroid gland. Examination of the thyroidectomy specimen revealed a 1.4 cm parathyroid nodule located within the parenchyma of the right superior thyroid, with capsular and vascular invasion and local infiltration into surrounding thyroid tissue. We present only the eighth reported case of intrathyroidal parathyroid carcinoma and review the literature.


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