(AACE) Abbreviations, 4–6 Absorbed Radiation, 6, 199–200, 208, 3

Index A prognosis of, 329–330 AACE. See American Association of Clinical prophylaxis for, 330 Endocrinologists (AACE) radiation and, 224 Abbreviations, 4–6 radiation complications and, 328 Absorbed radiation, 6, 199–200, 208, 315. See also symptoms of, 324 Radiation treatment of, 326–329 cumulative activity of, 207 radiation for, 327–328 Acne, 141 radioiodine and, 329 Acupuncture, 15 summary of, 329 Adenoma, 116 surgery for, 327 follicular, 65–66, 76, 85, 111 Anaplastic transformation, 322 paraganglioma-like, 65–66 Anesthetic. See General anesthetic; Local anesthetic Adenomatoid goiter. See Hyperplastic colloid Angiosarcoma, 85–86 nodule Antithyroglobulin antibodies, 192 Adenomatous hyperplasia, 62–65 Aplastic anemia, 148 AGES, 167, 201, 225 ATA. See American Thyroid Association formula for, 166 Autonomous nodule, 116, 154. See also Plummer’s Albumin, 36 disease Alternative therapy, 14–15 percutaneous injection of ethanol into, 119 American Association of Clinical Endocrinologists thyrotoxicosis and, treatment of, 116–117 (AACE), 13 American Thyroid Association (ATA), 13 B AMES, 166–167, 201 Baby. See also Fetus Amiodarone, 180 cancer in, 313, 317 Anaplastic carcinoma, 4, 79–80, 85, 88, 111, 143, 154, hypothyroidism and, 316 240, 248, 321–335 intelligence level of, 313, 317 chemotherapy and, 328 radiation exposure to, 308–309 children and, 296 B cell lymphoma, 84–85 clinical features of, 323 Benign tumor. See Nodule definition of, 79 Bleeding, 171 diagnosis of, 324 Bovine TSH, 175 etiology of, 321–323 Breast cancer, 238, 378–379, 381–382 experimental approaches to, 330–331 children and, 296 insular carcinoma and, 257 131I and, 221 131I therapy for, 222, 330 multimodality treatments for, 328–329 C pathology of, 323 Calcitonin, 49–50, 57, 60, 78, 81–82, 86, 151, 342–343, patient characteristics and, 323 346, 354, 357 385 386 Index Calcitonin (cont.) 123I treatment in, 291 elevated levels of, 352 Levo-thyroxine and, 289 measurement of, 345 limited workup in, 286 cAMP. See Cyclic AMP lobectomy in, 286 Cancer seeking radiopharmaceuticals, 105–106 low iodine diet for, 291 Carcinoma, 1. See also Anaplastic carcinoma; lymph node metastases in, 287, 298 Insular carcinoma; Papillary carcinoma myelogenous leukemia in, 297 c-cell origin of, 80–82 NIS in, 287–288 embolization of, 244–245 nodules in, 109–110, 285–287 mucoepidermoid, 84 papillary carcinoma in, 287, 297 poorly differentiated, 78, 255 PET scan in, 295–297 primary squamous cell, 86 postoperative complications with, 289 retinoic acid and, 246 postoperative scans in, 293 word usage, 6 postoperative timeline with, 290 Carcinoma showing thymus-like element (CASTLE), prepubertal, 2 83 radiation and, 291 CAT scan. See CT scan radioiodine treatment for, 289–297 C cell, 87–88, 337–338, 341, 348, 357. See also controversies of, 296–297 Parafollicular cell RET proto-oncogene in, 347 hyperplasia and, 347–348 scintiscan of, 285 Cervical lymph node, 108 Sistrunk procedure in, 287 Chemotherapy, 197–198, 331, 370 stunning of, 291, 296 anaplastic carcinoma and, 328 thymus and, 295 medullary carcinoma and, 348–351 thyroglobulin and, 293, 296–297 Chernobyl reactor accident, 76, 97, 135–136, 145, thyroglossal cyst in, 287 157, 255 thyroid cancer etiology in, 284 adult incidence of thyroid cancer from, 146 thyroid cancer in, 283–302 children and, 284 incidence of, 284 papillary carcinoma from, 76, 146, 153–154 long-term management of, 294 quantities of radionuclides released from, 145 pathology of, 287–288 Chest scan, 190–191 rhTSH treatment for, 292–293 Children surgery for, 288–289 anaplastic carcinoma and, 296 treatment of, 288, 290–291 cancerous nodule in, 124 thyroidectomy in, 283, 286, 289, 297–298, 347 Chernobyl reactor accident and, 284 thyroid hormone and, 289–290 Cowden’s syndrome in, 296 thyroid nodule in, 297 differentiated thyroid cancer prognosis in, 297 diagnosis of, 285–287 external radiation in, 284 misdiagnosis of, 285 false positive scans in, 294 presentation of, 285–287 FNA in, 285–287, 297 thyroxine and, 290 follicular carcinoma in, 287 TSH and, 289 Gardner’s syndrome in, 296 ultrasound and, 293 hemithyroidectomy in, 288–289 Chronic lymphocytic thyroiditis. See Hashimoto’s Hodgkin’s disease in, 297 thyroiditis hypoparathyroidism in, 289 Cochran’s heterogeneity statistic (Q), 12 hypothyroidism in, 284 Coherent scatter, 150 131I treatment in, 283, 286, 289–290, 293, 298 Collimator, 188, 191 breast cancer after, 296 Colloid, 32–35, 50, 59, 62, 64 complications and long term problems with, nodule, 63–65, 96, 115 294–296 Comet tail, 107 dosage of, 291–292 Compton scatter, 149–151 fertility in, 294–295 Computed tomographic scan. See CT scan management after, 293–294 Confidence intervals, 8–9 nausea in, 294 equation for, 8 offspring of, 296 Core biopsy, 109 pregnancy testing prior to, 296 Cowden’s syndrome, 155, 261 reduced sperm count in, 295 children and, 296 stunning by, 291, 296 Cranial nerve XI, 28 Index 387 CT (computed tomographic) scan, 139, 157, 164, Endocrine gland, 21, 49 179, 184, 205, 238, 241–243, 257, 260, 344, Endocytosis, 35 350, 368–369, 380 Equilibrium-absorbed dose constant, 207–208 PET scan and, 239 Estrogen, 32, 36, 195, 303 sensitivity of, 238 thyroid cancer and, 157 Cumulative activity, 207 Ethanol, 122, 124 Cyclic AMP, 28–29, 45 intracystic injection of, 120 Cyst, 96, 106, 247 intranodular injection of, 119 causes of, 70 side effects of, 119 determination of, sensitivity and specificity of, Euthyroid, 98–100, 101, 116–117, 121, 180, 210–211, 69 253 midline, 70 pregnancy and, 308, 316 Cystic lesions, 70 Evidence-based medicine, 10–11 Cystic nodule, 110 basis of, 12 definition of, 10 D External clinical evidence, 10 Death rate, 2 Degrees of freedom (df), 12 F Deiodinase, 36–37, 39–40 False positive findings, 185–191 Depression Familial differentiated thyroid carcinoma, 154, 164, hypothyroidism and, 175 261–262 thyroid cancer and, 175 prognosis of, 261 De Quervain’s thyroiditis, 324. See also Subacute Familial medullary carcinoma, 80, 88, 97, 135, 152, thyroiditis 155, 337, 339, 347, 356–357 Diagnostic accuracy, 111–113 categories of, 15 Diagnostic scanning, 173–181, 236–237 mutations associated with, 341 hypothyroidism and, 173–175 Familial non-medullary carcinoma. See Familial 124I and, 209 differentiated thyroid carcinoma postoperative timeline, 174 Familial tumors, 81 preparation for, 173 Family history, 97 rhTSH and, 211 Fetal thyroid, 314 timing of, 231–232 Fetus. See also Baby Dialysis, 223–224 absorbed radiation in, 315 Diet, low iodine, 178–180, 231, 237, 257, 262 hypothyroidism in, 312–313 children and, 291 radiation and, 312–316 hypothyroidism and, 179 followup testing for, 313 new mothers and, 309 legal ramifications of, 315, 317 Differentiated thyroid cancer, 3, 155, 163–282, 225, Fine needle aspiration (FNA), 25, 58, 60, 63, 65, 68, 248, 261, 322, 331 79, 86–87, 96, 101, 105–113, 116, 124, 172, child’s prognosis for, 297 238, 240, 247, 249, 252, 256–258, 261, 285, controversy management concerning, 225 324, 342–343, 346, 349, 357–358, 365, 368, definition of, 163 371–372, 377, 380, 382 ectopic location of, 246–254 benign diagnosis from, 110 familial, 164, 261–262 children and, 285–287, 297 natural history of, 164–165 guided, 112–113, 120, 352 presentation of, 163–164 interpretation of, 110–111 prognoses of, 165 papillary carcinoma and, 72 variants of, 4, 74, 163, 262 pregnancy and, 305–306, 316 Dosimetry, 199, 202, 206–211, 221, 223 problems with, 111 badges for, 214 repeat of, 114 diagnostic 124I using, 209 sensitivity and specificity of, 111 Non-excessive marrow, lung and total body techniques for, 108–110 radiation and, 209–210 Follicle, 49, 59, 64 structure of, 28 E Follicle stimulating hormone (FSH), 175, 222 Empiric therapy for ablation of remnants, 201–204 Follicular adenoma, 65–66, 76, 85, 111 Empiric therapy for metastases treatment, definition of, 65 204–206 uncommon variants of, 66 388 Index Follicular carcinoma, 3, 74, 76–78, 88, 100, 111, 114, Hashimoto’s thyroiditis, 68, 78, 84, 98, 101, 147, 192, 156, 163–164, 205, 244, 248, 251 240, 258, 365–366, 368, 371 children and, 287 primary thyroid lymphoma and, 367 familial, 154 HCG. See Human chorionic gonadotropin insular carcinoma and, 257 Hematolymphoid neoplasms, 84–85 metastatic, 164, 252 Hematoma, 262 poorly differentiated, 78–79 formation of, 109 variants of, 88, 258–261 postoperative occurrance of, 171 Follicular cell, 29–30, 33–35, 57, 62, 87–88, 173, 262, Hodgkin’s lymphoma, 85, 135, 136, 240 284, 321 children and, 297 Follicular lesions, 65 Hormone. See Thyroid, hormones of Free-3,5,3¢,5¢ tetraiodothyronine, 5 Horner’s syndrome, 27–28 FSH. See Follicle stimulating hormone Human apical iodide transporter, 33 FT4, 4, 196, 210, 305 Human chorionic gonadotropin (HCG), 175, 304, 314 index formula for, 303 Hürthle cell carcinoma, 63, 65, 68, 78, 81, 88, 104, 111, 154, 205, 240, 248, 255, 258–261, 262, G 321, 324 Gallium-67 (67Ga), 105, 148, 368 clinical features of, 259 Gardner’s syndrome, 155 diagnosis of, 259 children and, 296 familial, 155 Gastrointestinal tract, 29 papillary carcinoma and, 76 General anesthetic, 240 patient characteristics of, 259 inherent risks of, 172 prognosis of, 260 Genetic engineering, 50 summary of, 260 Glucose, 238–239 thyroid carcinoma and, 260–261 Goiter, 23, 29–30, 46, 104, 122, 124, 247, 304–305, 331, treatment of, 259–260 365, 371 Hürthle cell neoplasm, 258–259 asymptomatic, 121 Hyalinizing trabecular, 65–66, 83 causes of, 62 Hydrogen peroxide, 35 multinodular, 23, 76, 86, 102–104, 107, 125, 155, Hyperparathyroidism, 337, 343, 357 322, 378 Hyperplastic

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