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Morphological changes in a hyperfunctioning thyroid adenoma after percutaneous ethanol injection: Histological, enzymatic and sub-microscopical alterations

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Abstract

Ultrasound-guided ethanol injection (PEI) is an effective treatment of autonomously functioning thyroid nodules (AFTN) but little is known about the tissue lesions induced by alcohol. We report morphological changes of an AFTN which was removed after successful PEI treatment. At histological evaluation, the adenoma showed multiple areas of coagulative necrosis with eosinophilic ghost follicles, hemorrhages, small vessel thrombosis and a wedge-shaped hemorrhagic infarction. The peripheral adenomatous tissue and the surrounding thyroid parenchyma were free of regressive changes and/or lympho-monocytic inflammatory reactions. Enzyme histochemistry confirmed the hyperfunctioning character of the lesion and showed reduction of succinic dehydrogenase and cytochrome-c-oxydase activity in the viable tissue surrounding the central necrotic areas. By electron microscopy, the hyperfunctioning follicular epithelium showed submicroscopical alterations of the adenomatous cells surrounding the areas of coagulative necrosis. These results suggest that control of hyperthyroidism, after PEI, is due to: a) directly induced, irreversible damage (coagulative necrosis and vascular thrombosis with hemorrhagic infarction) in the central areas of the lesion; b) potentially reversible damage (reduction of intracellular enzyme activity and ultrastructural changes) in the peripheral areas.

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References

  1. Livraghi T., Paracchi A., Ferrari C., Bergonzi M., Garavaglia G., Raineri P., Vettori C. Treatment of autonomous thyroid nodules with percutaneous ethanol injection: preliminary results. Radiology 175: 827, 1990.

    CAS  PubMed  Google Scholar 

  2. Papini E., Panunzi C., Pacella C.M., Bizzarri G., Fabbrini R., Petrucci L., Pisicchio G., Nardi F. Percutaneous ultrasound-guided ethanol injection: a new treatment of toxic autonomously functioning thyroid nodules? J. Clin. Endocrinol. Metab. 76: 411, 1993.

    Article  CAS  PubMed  Google Scholar 

  3. Papini E., Panunzi C., Pacella C.M., Bizzarri G., Fabbrini R., Petrucci L., Pisicchio G., Nardi F. Percutaneous ultrasound-guided ethanol injection (PEI) in the treatment of toxic thyroid nodules (Abstract). J. Endocrinol. Invest. 15 (Suppl. 1 to no. 4): 150, 1992.

    Google Scholar 

  4. Linsk J.A., Franzen S. Fine needle aspiration for the clinician. JB Lippincott Company, Philadelphia, 1986, p. 16.

    Google Scholar 

  5. Livraghi T., Festi D., Monti F., Salmi A., Vettori C. US-guided percutaneous alcohol injection in small hepatic and abdominal tumors. Radiology 161: 309, 1986.

    CAS  PubMed  Google Scholar 

  6. Solbiati L., Giangrande A., DePra L., Bellotti E., Cantù P., Ravetto C. Percutaneous ethanol injection of parathyroid tumors under US guidance: treatment for secondary hyperparathyroidism. Radiology 155: 607, 1985.

    CAS  PubMed  Google Scholar 

  7. Pacella C.M., Papini E., Bizzarri G., Picardi R. Hepatocellular carcinoma: Magnetic resonance imaging after ultrasonically guided percutaneous alcohol treatment. Preliminary report. Ital. J. Gastroenterol. 22: 136, 1990.

    CAS  PubMed  Google Scholar 

  8. Shiina S., Tagawa K., Unuma T., Terano A. Percutaneous ethanol injection therapy for the treatment of hepatocellular carcinoma. AJR 154: 947, 1990.

    Article  CAS  PubMed  Google Scholar 

  9. Paracchi A., Ferrari C., Livraghi T., Reschini E., Macchi R.M., Bergonzi M., Raineri P. Percutaneous intranodular ethanol injection: A new treatment for autonomous thyroid adenoma. J. Endocrinol. Invest. 15: 353, 1992.

    CAS  PubMed  Google Scholar 

  10. Livraghi T., Paracchi A., Ferrari C., Reschini E., Macchi R.M., Bonifacino A. Treatment of autonomous thyroid nodules with percutaneous ethanol injection: 4-year experience. Radiology 190: 529, 1994.

    CAS  PubMed  Google Scholar 

  11. Martino E., Murtas M.L., Loviselli A., Piga M., Petrini L., Miccoli P., Pacini F. Percutaneous intranodular ethanol injection for treatment of autonomously functioning thyroid nodules. Surgery 112: 1161, 1992.

    CAS  PubMed  Google Scholar 

  12. Monzani F., Goletti O., Caraccio D., Del Guerra Federghini M., Pucci E., Baschieri L. Percutaneous ethanol injection treatment of autonomous thyroid adenoma: hormonal and clinical evaluation. Clin. Endocrinol. (Oxf.) 36: 491, 1992.

    Article  CAS  Google Scholar 

  13. Rinaldi R., Pacella C.M., Bizzarri G., Fabbrini R., Anelli V., Panunzi C., Papini E. Color Doppler in PEI treatment of hyperfunctioning thyroid nodules (Abstract). J. Endocrinol. Invest. (Suppl 2 to no. 3), 1994, p.71.

  14. Welzel B.K., Spicer S.S., Wollman S.H. Changes in fine structure and acid phosphatase localization in rat thyroid cells following thyrotropin administration. J. Cell. Biol. 25: 593, 1965.

    Article  Google Scholar 

  15. Seljelid R. Electron microscopic localization of acid phosphatase in rat thyroid follicle cells after stimulation with thyrotropic hormone. J. Histochem. Cytochem. 13: 687, 1965.

    Article  CAS  PubMed  Google Scholar 

  16. Dubowitz V. Muscle biopsy: a pratical approach, ed. 2. Baillere Tindall, London, 1985, p. 21.

    Google Scholar 

  17. Meissner W.A., Warren S. Tumor of thyroid gland, Atlas of tumor pathology, 2. Armed Forces Institute of Pathology, Washington, D.C., 1968, p. 19.

    Google Scholar 

  18. Tremblay G., Pearse A.G. Histochemistry of oxidative enzyme systems in the human thyroid, with special references to Askanazy cells. J. Path. Bact. 80: 353, 1960.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Section of Endocrinology and Metabolism, Histopatology Service, Rome, Italy

    E. Papini, R. Rinaldi, C. Panunzi & L. Petrucci

  2. Diagnostic Imaging Service, Ospedale Regina Apostolorum, Albano (RM), Rome, Italy

    C. M. Pacella, R. Fabbrini, G. C. Bizzarri & V. Anelli

  3. Department of Experimental Medicine, University La Sapienza, Policlinico Umberto I, Rome, Italy

    F. Nardi & V. Marinozzi

  4. Servizio di Istopatologia, Ospedale Regina Apostolorum, Via. S. Francesco 50, 00041, Albano Laziale, Roma, Italy

    A. Crescenzi M.D.

Authors
  1. A. Crescenzi M.D.
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  2. E. Papini
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  3. C. M. Pacella
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  4. R. Rinaldi
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  5. C. Panunzi
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  6. L. Petrucci
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  7. R. Fabbrini
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  8. G. C. Bizzarri
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  9. V. Anelli
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  10. F. Nardi
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  11. V. Marinozzi
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Crescenzi, A., Papini, E., Pacella, C.M. et al. Morphological changes in a hyperfunctioning thyroid adenoma after percutaneous ethanol injection: Histological, enzymatic and sub-microscopical alterations. J Endocrinol Invest 19, 371–376 (1996). https://doi.org/10.1007/BF03344972

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  • DOI: https://doi.org/10.1007/BF03344972

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