BROOKHAVEN NATIONAL LABORATORY | Name HOSPITAL of the MEDICAL RESEARCH CENTER (Rongelap 18) UPTON, NEW YORK DISCHARGE SUMMARY ADMITTED: PAVILION Aug. 26, 1969 DISCHARGED: Hospital for evaluation of a nodular-thyroid gkand. to fallout. UNIT+ NO, 08-22-58R 1 OPD Sept. 22, 1969 This 36-year-old Marshallese woman was admitted to this The patient was 2l-years of age at the time of exposure She was in the more heavily exposed group, receiving an estimated 175 rads of whole body gamma radiation, beta radiation to the skin, and internal absorption of radioisotopes, from radioiedines Her thyroid gland received an estimated 160 rads absorbed, plus 175 rads from whole body exposure, She had signs of mild hematopoietic depression shortly after exposure but no signs of Do Not Write In Binding Margin infection or bleeding and by one year her blood elements ‘had recovered to normal levels, During the early period she also experienced mild transient beta burns to the skin. HISTORY OF PRESENT ILLNESS: Her thyroid abnormality was detected for the first time this past March when a multi-lobulated mass in the left lower pole of the thyroid was noted. Up until chis time she had always appeared to be euthyroid. A serum sample taken at that time of examination showed a T-4 level of 3.9 ug.%. This is the third adult case in the more heavily exposed group that has developed thyroid pathology. The patient claims she had been taking her thyroid-hormone therapy regularly. Two of her sons, who were less than 10 years of age at exposure, have had excisions of benign nodules during the past two years, PHYSICAL EXAMINATION: This mother of nine children appeared to be in excellent health. She appeared to be euthyroid, The only positive findings of significance in her physical examination were referable to the thyroid gland. Since the examination in March a discrete mass in the right upper pole was noted for the first time, The mass was hard and spherical, noted in the lower left lobe. Less distinct nodulation was No lymphadenopathy was noted. LABORATORY AND X-RAY DATA: The thyroid studies revealed ; the following: PBI 9.2 ug.%, total iodine 9,2 ug.%, Llodoprotein 2.3 ug.%, and T-4 6,2 ug.%; thyroid autoantibodies less than 1-16; thyroid scan showed a non-functioning nodule in the right upper lobe; uptake of radioiodine showed normal function of the gland; iodine uptake response to TSH stimulation, however, was poor. The 997. srudies showed good trapping function; cholesterol 172 mg.%, esters 120 mg.%. Her BMR was +16, Positive stool examinations from ascaries and trichuris was the only other positive laboratory finding of significance. The high sedimentation rate and reversal of the A/G ratio is common to the Marshallese people. X-ray of the chest was negative, BNL 720A - 78 =