Index A c of well-differentiated thyroid Adenoma, follicular, 19 C cell hyperplasia, 83, 113, 120 carcinoma, 205-206 Adenosquamous thyroid carci- C cells, 116, 120-121 Childhood nontoxic goiter, 46 noma, 148-149 Calcitonin, 120-123 CHOP (cyclophosphamide, dox­ Adriamycin, 134, 158 Calcitonin gene-related peptide orubicin, vincristine and AOES classification schema, lO- (CORP),123 prednisone), 170,209 II Cancer, thyroid, see Thyroid car­ Chromogranin, 123 AMES scale, 11-12 cinoma CIS-platinum, 134 Amiodorone, 103 Capsular invasion, 20, 21 Clear nuclei, 2 Amyloid, 113, 118 Carcinoembryonic antigen Colloid nodule formation, 38-39 Anaplastic thyroid carcinoma (CEA),208-209 Core biopsy (CB), 19 (ATC), 60, 82-83, 142- Carcinoma Cowden's syndrome, 17 159 insular, 20, 148 Cyclophosphamide, doxorubicin, chemotherapy, 157-158,206- metastatic to thyroid gland, vincristine and prednisone 208 177-181 (CHOP), 170, 209 clinical picture, 143-144 recurrent, of childhood, 46 diagnosis, 154-156 small cell, 148 external radiation treatment, squamous cell, 147-148 D 195,200-202 thyroid, see Thyroid carcinoma Delphian node, 45 incidence, 143 CB (core biopsy), 19 Diiodotyrosine (DIT), 86-87 pathology, 144-150 CEA (carcinoembryonic antigen), Diploid cells, 9-10 pathophysiology, 150-154 208-209 DIT (diiodotyrosine), 86-87 radiation therapy, 157 Cervical adenopathy, 4-5 DNA ploidy, 9-10 surgery, 156-157 Cervical lymphadenopathy, 48 DOPA-decarboxylase, 123 survival data, 158-159 Cervical node metastases, 6 Doxorubicin, 134, 205-206 therapy, 156-158 CORP (calcitonin gene-related Dyshormonogenetic goiter, 46 Aneuploid cells, 9-10 peptide), 123 Antithyroid drugs, 103 Chemotherapy APUD-cell tumors, 118, 123, of advanced thyroid carci­ E 208 noma, 204-211 EOF (epithelial growth factor), Askanazy cell carcinoma, 16 of anaplastic thyroid carci- 150 ATC, see Anaplastic thyroid noma, 157-158,206-208 Endocrine-dependent tumors, carcinoma biological basis for, 204 102 Autoimmune thyroiditis, 47-48 clinical goals for, 204-205 EORTC (European Organization current recommendations, 210- for Research on Treatment 211 of Thyroid Cancer) index, B of medullary thyroid carci­ 10-12 Bilateral resection, 54 noma, 134,208-209 Epithelial growth factor (EOF), Biogenic amines, 117-119 principles of, 204-205 150 Bony metastases, 106 of thyroid lymphoma, 171, Epithelial tumor markers, Brain metastases, 58 209-210 149 215 216 INDEX European Organization for Re­ Hodgkin's disease, primary, of cytometry, 124-125 search on Treatment of thyroid gland, 174 demographics, 112 Thyroid Cancer (EORTC) Hormonal tumor markers, 149 detection of residual disease, index, 10-12 Hiirthle cell cancer, 77 132-133 Hiirthle cell carcinoma, 16 disease probability statistics, Hiirthle cell tumors, 26, 66 130-131 F Hypercalcitoninemia, 132 external radiation treatment, Fine needle aspiration (FNA), 19, Hyperparathyroidism, 42, 106 189,194,200 50-51, 155, 163-164 Hyperthyroxinemia, 108 familial, 83, 125-127 technique of, 67 Hypoparathyroidism, 54, 69-70, histopathology, 113, 116-118 FMD (moderately differentiated 80,106 molecular biology, 134-137 follicular carcinoma), 20- pathologic variants, 119-120 21 prognostic features, 124 FNA, see Fine needle aspiration I radiation therapy, 133-134 Focal hyperplasia, 38 Immunoenzymometry (lEMA), screening studies, 127-129 Follicular adenoma, 19 90 sporadic, 83 Follicular thyroid carcinoma, 16- Immunoradiometry (IRMA), 90 surgery for, 83-84, 131-132 29 Insular carcinoma, 20, 148 therapeutic modalities, 131- clear cell variant, 21, 23 Intermediate filaments, 150 134 clinical features, 17-19 Iodine, 100 Metastases epidemiology, 16-17 radioactive, see Radioactive io- bony, 106 external radiation treatment, dine brain, 58 185-188, 193 Iodine deficiency, 151 cervical node, 6 minimally invasive, 20 Iodine dyes, 103 distant, 105 moderately differentiated Iodine intake, 16-17 lung, 58, 105 (FMD), 20-21 Ipsilateral lobectomy, 54 neck node, 78, 82 oxyphilic cell type, 21, 23 IRMA (immunoradiometry), 90 to thyroid gland, 177-181 pathology, 19-23 Irradiation, neck, 46-47 Midline compartment recurrence, prognosis, 23-26 Isotopic scanning, 101 79-80 treatment, 23-29 Minimally invasive follicular car­ well-differentiated (FWD), 20- cinoma,20 21 J Monoiodotyrosine (MIT), 86-87 widely invasive, 20, 22 Jugular lymph nodes, 83-84 Multicentricity, 5-6, 69 Frozen section, 68 FWD (well-differentiated follicu­ lar carcinoma), 20-21 L N Large needle biopsy, 155 Near-total thyroidectomy, 75, Levothyroxine, 82 76 G Lithium, 103 Neck dissection Gallium 67 imaging, 163 Lobectomy, thyroid, 68-69 modified, 54 Gastrin-releasing peptide (GRP), ipsilateral, 54 technique of, 78-79 123-124 Lung metastases, 58, 105 Neck irradiation, 46-47 Gene mutation rate, 54 Lymph gland involvement, 39 Neck node metastases, 78, 82 Giant cell undifferentiated can­ Lymph nodes, jugular, 83-84 Needle biopsy, 19 cers, 60 Lymphadenopathy, cervical, 48 file, see Fine needle aspiration Giant cells, 145-147 Lymphocytic infiltration, 166 large, 155 Goiter, 16-17,36-37, 151 Lymphoma of thyroid gland, see Nerve growth factor, 134 childhood nontoxic, 46 Thyroid gland lymphoma Nodularity, thyroid, 45, 47 dyshormonogenetic, 46 Nontoxic goiter, 46 Granules, secretory, 116 Nuclear groove, 2-3 Graves' disease, 11 M Nuclear ploidy, 9-10 GRP (gastrin-releasing peptide), Mass spectrometry, 80 123-124 Medullary thyroid carcinoma, 38, 39,112-137 o associated endocrinopathy, Occult papillary carcinoma of H 129-130 thyroid, 5, 7-9 Hashimoto's thyroiditis, 48 calcitonin and, 120-123 Octreatide, 134 Hemiagenesis, thyroidal, 45-46 chemotherapy, 134,208-209 Orphan Annie Eyes, 2-3 Hemorrhage, postoperative, 80 clinical presentation, 112-113 Osteoporosis, 56 Histaminase, 123 cytology, 113, 114-115 Oxyphil cell carcinoma, 16 p Radiation treatment for thyroid papillary, see Papillary thyroid Papillae, 1-2 carcinoma, 182-203 carcinoma Papillary thyroid carcinoma, 1- Radioactive iodine (RaI), 25, 27- pediatric, see Pediatric entries 13 29,41,54-55 radiation-induced, 32-42 external radiation treatment, adverse effects of, 106-108 radioactive iodine treatment of, 184-188, 193 protocols for, 103-104 100-109 extrathyroidal spread of, 6 secondary effects of, 108 residual, 104-105 larger than 1.5 cm, 4-7 treatment of thyroid carci- significance of microscopic dis­ less than 1.5 cm, 8 noma, 100-109 ease, 66-67 mortality data, 4, 6-7 Recurrent disease, management staging, 144 multicentricity of, 5-6 of, 81-82 undifferentiated, see Undiffer­ nucle'lf DNA content in, 9-10 Roentgen ray therapy, 32 entiated thyroid carcinoma occult, 6, 7-9 well-differentiated, see Well­ pathology, 1-3 differentiated thyroid car­ predictive models, 10-12 S cinoma treatment, 12-13 Sarcomatous tumor markers, 149 Thyroid gland Parafollicular cells, see C cell en- Secretory granules and vacuoles, amount removed, 68-70 tries 116 carcinoma metastatic to, 177- Parathyroid disease, 130 Sialoadenitis. 106 181 Parathyroid glands, 73, 74 Small cell carcinoma, 148 lymphoma of, see Thyroid Pediatric thyroid carcinoma, 45- Spindle cells, 147 gland lymphoma 61 Spindle undifferentiated cancers, pediatric, 45-46 clinical presentation, 48-49 60 plasmacytoma of, 172-174 demographics, 46 Squamoid pattern, 148 primary Hodgkin's disease of, diagnostic approach, 49-51 Squamous cell carcinoma, 147- 174 general survey, 46-51 148 Thyroid gland lymphoma, 162- identification of risk factors, 174 46-48 chemotherapy, 171,209-210 management of, 50 T clinical features, 162-164 natural history and cause of T3 (triiodothyronine), 86, 102 differential diagnosis, 164-165 death,51 Tapazole, 103 factors influencing survival, prognosis, 56-59 Teratoma, 60 172 sites of recurrence of, 52 Tetraiodothyronine, see Thyrox- histopathology, 165-167 surgical findings, 51 ineentries pathology, 165-168 varieties of, 51-60 Tetraploid cells, 9-10 pathophysiology, 168-169 Pediatric thyroid gland, 45-46 TO, see Thyroglobulin radiotherapy, 169-171 Pentagastrin, 121-122 Thyrocalcitonin, 83 recommendations for treat- Perchlorate, 103 Thyroglobulin (TO), 56, 86-97 ment,I71-172 Pheochromocytoma, 125-126 classic, 86 surgery, 169 Plasmacytoma of thyroid gland, genetic abnormalities in forma- therapy, 169-171 172-174 tion of, 87-88 Thyroid hormonal treatment of Postoperative hemorrhage, 80 measurement, 89-97 papillary cancer, 12-13 Pregnancy, 106 physiology, 88-89 Thyroid hormone formation, 86- Primary Hodgkin's disease of structure and synthesis, 86 87 thyroid gland, 174 Thyroid carcinoma Thyroid lobectomy, see Lobec­ Propylthiouracil, 103 adenosquamous, 148-149 tomy, thyroid Psammoma bodies, 3, 39, 49 advanced, chemotherapy of, Thyroid neoplasia, 33 Pulse oximeter, 80 204-211 uncommon, 59-60 amount of thyroid removed in, Thyroid nodularity, 45, 47 68-70 surgical approach to, 67-68 R anaplastic, see Anaplastic thy- Thyroid stimulating antibody Radiation-induced thyroid carci- roid carcinoma (TSAb),17 noma, 32-42 classification, 65-66 Thyroid-stimulating hormone definition, 32-33 differentiated, 16 (TSH), 13, 17,27,55-56, diagnosis and treatment, 39-42 external radiation treatment 82, 101-102, 153-154 estimated risk of, 35, 36 for, 182-203 Thyroid storm, 108 incidence, 33-38 follicular, see Follicular thyroid Thyroid suppression therapy, 55- pathology, 38-39 carcinoma 56 radiation dose factors in, 34-38 medullary, see Medullary thy­ Thyroid teratoma, 60 Radiation threshold, 34 roid carcinoma Thyroid tissue, altered, 179 Thyroidal hemiagenesis, 45-46 TSAb (thyroid stimulating anti­ W Thyroidectomy, 26-28 body),17 Well-differentiated