PATIENT NO, 61 (continued)
and development has appeared to be entirely normal, if mot somewhat precocious.
A l cm nodule of the left lower pole of the thyroid was noted in September, 1965,
which did not decrease on thyroid hormone therapy.

The patient was obese.

Physical Examination:

She appeared to be euthyroid

Her cholesterol was slightly elevated

with PBIs in the normal Marshallese range.
“in 1957 (277 mg).

The remainder of the physical

examination was essentially negative except for slight acne and dental caries.

PBI was 7.5 wg% with thyroxin
Thyroid Studies:
Laboratory and X-Ray Data:
Cholesterol
Ancithyroglobulin titre was 1:32.
iodine 4.9 yeh; T3 was 12.9%.

Thyroid scan using 99m~¢ showed normal uptake

was 162 mg% (esters 151 mg%).

but the gland was asymmetrical, with the right lobe showing uptake only in the
upper portion.
A “hot" nodule was noted in the lower left pole of the thyroid,
1327 uptake was normal and there was normal increase in uptake following TSH
stimulation,
The chest plate and EKG were normal.
The remainder of the laboratory studies were essentially negative except for an increased sedimentation rate

which is an unexplained finding in most of the Marshallese.
Hospital Course:

Following the studies at this hospital,

ferred to the New England Deaconess Hospital

the patient was trans-~

in Boston on June 5,

1966.

On

June 8, Dr. Bentley P. Colcock of Lahey Clinic performed a bilateral subtotal

thyroidectomy removing a 1.5 cm nodule in the left lower thyroid lobe and a small

cyst in the right lower lobe,
Dr. W. A. Meissner of the New England Deaconess
Hospital examined the surgical specimens, and his pathological diagnosis was
“adenomatous goiter.'' Recovery from surgery was uneventful, and the patient was

readmitted to this hospital on June 11.
180 mg daily,

Diaznosis:

indefinitely.

She was placed on desiccated thyroid,

Her wound healed nicely, and she was asymptomatic.

Adenomatous goiter.

Discharge Medication:

Thyroid hormone therapy to be continued indefinitely.

This patient was seen in September, 1966, in the Marshall Islands, and she

was found to be euthyroid on the hormone therapy, with no complications.

PATIENT NO,
65
This

AGE
13

SEX

HOS PITAL

F

Hospital of Medical Research Center, BNL

DATE
June,

1966

13 year old Marshallese girl was admitted to this hospital for evaluation of

a 0.5 cm nodule of the right lobe of the thyroid gland discovered during the
past year.
History of Present Illness:

This child was exposed to fallout radiation in

1954 at 1 year of ave and received an estimated dose of 175 rads of whole-body

gamma radiation, irradiation of the skin from deposition of fallout material
thereon, and absorption of significant amounts of radionuclides from ingestion

of contaminated food and water.

It was estimated her thyroid gland received a

dose in the range of 700-1,400 rads trom radioiodines in the fallout and in
addition 175 rads from gamma radiation.
She had early gastrointestinal symptoms

Le

Select target paragraph3