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Therapiebedingte Veränderungen der Schilddrüse

Therapy related alterations to the thyroid gland

  • Schwerpunkt: Iatrogene Pathologie
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Zusammenfassung

Therapiebedingte Veränderungen der Schilddrüse gehen mit mehr oder weniger spezifischen morphologischen Veränderungen einher. Die Therapie kann dabei zur Behandlung schilddrüseneigener Störungen (in der Regel eine Überfunktion) durchgeführt worden sein (Thyreostatika, Radiojodtherapie), oder die Schilddrüse ist bei der Behandlung anderer Erkrankungen sekundär mitbetroffen (z. B. Bestrahlung, Amiodaron, Minocyklin). Der vorliegende Übersichtsartikel beschreibt die morphologischen Auffälligkeiten der wichtigsten therapiebedingten Veränderungen der Schilddrüse.

Abstract

Therapy related alterations to the thyroid gland are associated with more or less specific morphological changes. The therapy (thyrostatic drugs, radio-iodine) may be administered for the treatment of thyroid dysfunction (hyperthyroidism), or the thyroid gland is involved during or after the treatment (irradiation, various drugs) of primarily non-thyroid related diseases. The present review summarizes the most important morphological changes related to therapy.

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Literatur

  1. Alexander CB, Herrera GA, Jaffe K, Yu H (1985) Black thyroid: clinical manifestations, ultrastructural findings, and possible mechanisms. Hum Pathol 16:72–78

    PubMed  Google Scholar 

  2. Barclay ML, Brownlie BE, Turner JG, Wells JE (1994) Lithium associated thyrotoxicosis: a report of 14 cases, with statistical analysis of incidence. Clin Endocrinol (Oxf) 40:759–764

    Google Scholar 

  3. Benitz KF, Roberts GK, Yusa A (1967) Morphologic effects of minocycline in laboratory animals. Toxicol Appl Pharmacol 11:150–170

    Article  PubMed  Google Scholar 

  4. Berens SC, Bernstein RS, Robbins J, Wolff J (1970) Antithyroid effects of lithium. J Clin Invest 49:1357–1367

    PubMed  Google Scholar 

  5. Birkedal C, Tapscott WJ, Giadrosich K et al. (2001) Minocycline-induced black thyroid gland: medical curiosity or a marker for papillary cancer? Current Surgery 58:470–471

    Article  PubMed  Google Scholar 

  6. Cappiello E, Boldorini R, Tosoni A et al. (1995) Ultrastructural evidence of thyroid damage in amiodarone-induced thyrotoxicosis. J Endocrinol Invest 18:862–868

    PubMed  Google Scholar 

  7. Centeno BA, Szyfelbein WM, Daniels GH, Vickery AL Jr (1996) Fine needle aspiration biopsy of the thyroid gland in patients with prior Graves‘ disease treated with radioactive iodine. Morphologic findings and potential pitfalls. Acta Cytol 40:1189–1197

    PubMed  Google Scholar 

  8. Chiovato L, Martino E, Tonacchera M et al. (1994) Studies on the in vitro cytotoxic effect of amiodarone. Endocrinology 134:2277–2282

    Article  PubMed  Google Scholar 

  9. Clarke TJ, Simpson RH (1990) Necrotizing granulomas of peritoneum following diathermy ablation of endometriosis. Histopathology 16:400–402

    PubMed  Google Scholar 

  10. Curran RC, Eckert H, Wilson GM (1958) The thyroid gland after treatment of hyperthyroidism by partial thyroidectomy or iodine 131. J Pathol Bacteriol 76:541–560

    Article  PubMed  Google Scholar 

  11. Emerson CH, Dysno WL, Utiger RD (1973) Serum thyrotropin and thyroxine concentrations in patients receiving lithium carbonate. J Clin Endocrinol Metab 36:338–346

    PubMed  Google Scholar 

  12. Freedberg AS, Kurland GS, Blumgart HL (1952) The pathologic effects of I131 on the normal thyroid gland of man. J Clin Endocrinol Metab 12:1315–1348

    PubMed  Google Scholar 

  13. Gittoes NJ, Franklyn JA (1995) Drug-induced thyroid disorders. Drug Saf 13:46–55

    PubMed  Google Scholar 

  14. Gordon G, Sparano BM, Kramer AW et al. (1984) Thyroid gland pigmentation and minocycline therapy. Am J Pathol 117:98–109

    PubMed  Google Scholar 

  15. Granter SR, Cibas ES (1997) Cytologic findings in thyroid nodules after 131I treatment of hyperthyroidism. Am J Clin Pathol 107:20–25

    PubMed  Google Scholar 

  16. Hanson GA, Komorowski RA, Cerletty JM, Wilson SD (1983) Thyroid gland morphology in young adults: normal subjects versus those with prior low-dose neck irradiation in childhood. Surgery 94:984–988

    PubMed  Google Scholar 

  17. Jennings TA, Sheehan CE, Chodos RB, Figge J (1996) Follicular carcinoma associated with minocycline-induced Black Thyroid. Endocr Pathol 7:345–348

    PubMed  Google Scholar 

  18. Jereczek-Fossa BA, Alterio D, Jassem J et al. (2004) Radiotherapy-induced thyroid disorders. Cancer Treat Rev 30:369–384

    Article  PubMed  Google Scholar 

  19. Kennedy JS, Thomson JA (1974) The changes in the thyroid gland after irradiation with 131I or partial thyroidectomy for thyrotoxicosis. J Pathol 112:65–81

    Article  PubMed  Google Scholar 

  20. Kontozoglou T, Mambo N (1983) The histopathologic features of lithium-associated thyroiditis. Hum Pathol 14:737–739

    PubMed  Google Scholar 

  21. Kurosumi M, Fujita H (1986) Fine structural aspects on the fate of rat black thyroids induced by minocycline. Virchows Arch B Cell Pathol Incl Mol Pathol 51:207–213

    PubMed  Google Scholar 

  22. Landas SK, Schelper RL, Tio FO et al. (1986) Black thyroid syndrome: exaggeration of a normal process? Am J Clin Pathol 85:411–418

    PubMed  Google Scholar 

  23. Lazarus JH (1998) The effects of lithium therapy on thyroid and thyrotropin-releasing hormone. Thyroid 8:909–913

    PubMed  Google Scholar 

  24. Lindsay S, Dailey ME, Jones MD (1954) Histologic effects of various types of ionizing radiation on normal and hyperplastic human thyroid glands. J Clin Endocrinol Metab 14:1179–1218

    PubMed  Google Scholar 

  25. Li Volsi V (1990) Nonneoplastic conditions. In: Bennington J (ed) Surgical pathology of the thyroid. WB Saunders, Philadelphia London Toronto Montreal Sydney Tokyo, pp 68–97

  26. Mahmoud I, Colin I, Many MC, Denef JF (1986) Direct toxic effect of iodide in excess on iodine-deficient thyroid glands: epithelial necrosis and inflammation associated with lipofuscin accumulation. Exp Mol Pathol 44:259–271

    Article  PubMed  Google Scholar 

  27. Malizia AA, Jr., Reiman HM, Myers RP et al. (1984) Migration and granulomatous reaction after periurethral injection of polytef (Teflon). JAMA 251:3277–3281

    Article  PubMed  Google Scholar 

  28. Manson CM, Cross P, De Sousa B (1992) Post-operative necrotizing granulomas of the thyroid. Histopathology 21:392–393

    PubMed  Google Scholar 

  29. Martino E, Macchia E, Aghini-Lombardi F et al. (1986) Is humoral thyroid autoimmunity relevant in amiodarone iodine-induced thyrotoxicosis (AIIT)? Clin Endocrinol (Oxf) 24:627–633

    Google Scholar 

  30. Martino E, Bartalena L, Bogazzi F, Braverman LE (2001) The effects of amiodarone on the thyroid. Endocr Rev 22:240–254

    Article  PubMed  Google Scholar 

  31. McNicol AM, Lewis PD (1996) The thyroid gland. In: Lewis PD (ed) The endocrine system. Churchill Livingstone, New York Edinburgh London Madrid Melbourne San Francisco Tokyo, pp 131–185

  32. Mehbod H, Swartz CD, Brest AN (1967) The effect of prolonged thiazide administration on thyroid function. Arch Intern Med 119:283–286

    Article  PubMed  Google Scholar 

  33. Mizukami Y, Michigishi T, Nonomura A et al. (1995) Histological features of the thyroid gland in a patient with lithium induced thyrotoxicosis. J Clin Pathol 48:582–584

    PubMed  Google Scholar 

  34. Nollevaux MC, Burlet M, Squifflet JP et al. (2002) Is the black thyroid really an innocuous pathological finding? Acta Clin Belg 57:158–161

    PubMed  Google Scholar 

  35. Oppenheimer JH, Tavernetti RR (1962) Studies on the thyroxine-diphenylhydantoin interaction: effect of 5,5’-diphenylhydantoin on the displacement of L-thyroxine from thyroxine-binding globulin (TBG). Endocrinology 71:496–504

    PubMed  Google Scholar 

  36. Prince RL, Worth GK, Shenfield GM (1980) Sulphonylurea therapy and hypothyroidism. Practitioner 224:1287–1289

    PubMed  Google Scholar 

  37. Roberts JT, Roberts GT, Maudsley RF (1977) Indolent granulomatous necrosis in patients with previous tubal diathermy. Am J Obstet Gynecol 129:112–113

    PubMed  Google Scholar 

  38. Saad A, Falciglia M, Steward DL, Nikiforov YE (2004) Amiodarone-induced thyrotoxicosis and thyroid cancer: clinical, immunohistochemical, and molecular genetic studies of a case and review of the literature. Arch Pathol Lab Med 128:807–810

    PubMed  Google Scholar 

  39. Smyrk TC, Goellner JR, Brennan MD, Carney JA (1987) Pathology of the thyroid in amiodarone-associated thyrotoxicosis. Am J Surg Pathol 11:197–204

    PubMed  Google Scholar 

  40. Spitalnik PF, Straus FH (1978) Patterns of human thyroid parenchymal reaction following low-dose childhood irradiation. Cancer 41:1098–1105

    PubMed  Google Scholar 

  41. Valdiserri RO, Borochovitz D (1980) Histologic changes in previously irradiated thyroid glands. Arch Pathol Lab Med 104:150–152

    PubMed  Google Scholar 

  42. Wenig BM, Heffess CS, Adair CF (1997) Nonautoimmune Thyroiditis. In: Wenig BM, Heffess CS, Adair CF (eds) Atlas of endocrine pathology. WB Saunders, Philadelphia London Toronto Montreal Sydney Tokyo, pp 50–61

  43. Wilson GE, Haboubi NY, McWilliam LJ, Hirsch PJ (1990) Postoperative necrotising granulomata in the cervix and ovary. J Clin Pathol 43:1037–1038

    PubMed  Google Scholar 

  44. Yassa R, Saunders A, Nastase C, Camille Y (1988) Lithium-induced thyroid disorders: a prevalence study. J Clin Psychiatry 49:14–16

    Google Scholar 

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Sheu, S.Y., Levin, S. & Schmid, K.W. Therapiebedingte Veränderungen der Schilddrüse. Pathologe 27, 13–18 (2006). https://doi.org/10.1007/s00292-005-0813-y

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