Pathogenesis of nodular goiter and its implications for surgical management
Despite sufficient iodine supply, goiter continues to be of considerable surgical significance in formerly endemic countries. It now appears that iodine deficiency and increased thyrotropin stimulation are not the only causes of goiter. Xenotransplantation of human thyroid tissue onto nude mice allowed study of the regulation of growth and function in human goiter tissue. Grafts of human thyroid tissue growing in nude mice could be shown to react to endogenous mouse thyrotropic stimulation and suppression. /sup 131/I autoradiographs of xenotransplanted goiter tissue showed as marked a heterogeneity as did the original goitrous tissue prior to transplantation. There was no firm correlation between the morphologic appearance of a follicle and its iodine metabolism. Scintigraphically cold and hot goiter tissue differed from each other quantitatively but not qualitatively; i.e., both hot and cold tissue were composed of metabolically active and nonactive follicles. Iodine organification was not completely suppressible by thyroxine treatment; this indicates autonomous functional activity. The distribution of proliferating tissue labeled by /sup 3/H-thymidine did not parallel the distribution of functionally active tissue labelled by /sup 131/I. Thyroxine treatment did not completely inhibit /sup 3/H-thymidine incorporation, indicating autonomous growth. Thus, our pathogenetic concept of goiter formation is based on three mainstays: (1) goiter heterogeneity, (2) autonomy of growth and function, and (3) dissociation of growth and function in human goiter tissue. Thus, the surgeon dealing with goiter ought to remove all pathologically altered tissue, i.e., nodular tissue, irrespective of its appearance on scintiscans.
- Research Organization:
- Univ. of Bern, Switzerland
- OSTI ID:
- 5359497
- Journal Information:
- Surgery; (United States), Journal Name: Surgery; (United States) Vol. 103:1; ISSN SURGA
- Country of Publication:
- United States
- Language:
- English
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59 BASIC BIOLOGICAL SCIENCES
AMINO ACIDS
ANIMALS
AUTORADIOGRAPHY
AZINES
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BIOLOGICAL MODELS
BODY
CARBOXYLIC ACIDS
DAYS LIVING RADIOISOTOPES
DISEASES
ELEMENTS
ENDOCRINE DISEASES
ENDOCRINE GLANDS
GLANDS
GOITER
HALOGENS
HETEROCYCLIC COMPOUNDS
HORMONES
INTERMEDIATE MASS NUCLEI
IODINE
IODINE 131
IODINE ISOTOPES
ISOTOPES
LABELLED COMPOUNDS
MAMMALS
METABOLISM
MICE
NONMETALS
NUCLEI
NUCLEOSIDES
NUCLEOTIDES
ODD-EVEN NUCLEI
ORGANIC ACIDS
ORGANIC COMPOUNDS
ORGANIC HALOGEN COMPOUNDS
ORGANIC IODINE COMPOUNDS
ORGANIC NITROGEN COMPOUNDS
ORGANS
PATHOGENESIS
PEPTIDE HORMONES
PYRIMIDINES
RADIOISOTOPES
RIBOSIDES
RODENTS
THYMIDINE
THYROID
THYROID HORMONES
THYROXINE
TRANSPLANTS
TRITIUM COMPOUNDS
VERTEBRATES