JS

cates some of the changes characteristic of these
benign nodules. In one case (No. 33), in addition
to adenomatoid nodules there also was present a
Hurthle’s cell adenoma. In another case (No. 61},

one pathologist remarked that ‘‘some observers
might regard the large noduleas follicular adenoma.” In subject No. 59, a 46-year-old woman
who had received less than half the radiation dose
of the other cases with nodules, there was a solitan
adenomatous nodule, well circumscribed, and the

surrounding thyroid tissue was normal in appearance. This was in contrast to the other cases in
whom the glands were almost enturely abnormal
in appearance. A 41-year-old woman (No. 64) had
a mixed papillary and follicular carcinoma of the
thyroid with localized metastasis to a blood vessel
and lymph node (Figure 26). Following complete
thyroidectomy by surgery and therapeutic ''']
no recurrenceorfurther metastasis has been noted.
In September 1966, at Tripler General Hospital,
Hawaii, thyroid uptake studies following TSH
stimulation (10 units daily for 2 days), thyroid
scans, and skeletal surveys for metastasis showed
absenceof the thyroid and no detectable metastasis.*
Thyroid Function Tests Related

to Thyroid Abnormalities and Growth Retardation
In Table 20 the cases with thyroid abnormali-

ties are listed along with the growth status of chil-

dren and results of thyroid function tests. The re-

Figure 24 Benign thyroid nodules at surgery. Top exposed thyrord with arrows potnting 10 nodules. Bottom
sectioned eland from another case Note multinodular,

oxsticl and hemorrhagic nature of gland.

Microscopic Appearance.

The microscopic ap-

pearance of all the benign nodular glands in the
children was characteristic of adenomatous goiter

and varied mainly in the degree of change. The
architecture of the gland was disrupted by the

nodules of widely varving sizes. Some of the nodules contained mucrofollicular elements with and
without colloid, others were atrophic, some contained large cvsts with colloid, some with hemor-

sults of kinetic analysis of '’*I tests are given in
Table 21. Two 12-year-old boys (No. 5 and No. 3)
who had been exposed at 15 and 18 monthsofage
respectively have had the greatest retardation of
growth and development. Subject No. 3 had
shown no change in bone maturation since 1961
and until recently had the bone age of a 3-vear
old child. The bone age of No. 5 has shown continuing slow growth and in 1965 was 3!% years
Both these boys in 1965 had the height of normal
7-year old Marshallese boys. Their dwarfism was

particularly evident in comparison with vounge!
siblings who weretaller than they. In 14965 it was
found tha: in both cases the levels of proteinbound iodine had dropped below2 ye’. Before

that me, they had levels considered to be in the
normal range, and there was no reason torelate

rhage, and sull others showed extensive prolifera-

their dwarfism to hypothyroidism. With the development of the low PBIs they showed definite

viving an Varboreal” appearance Figure 29 ind.

ring out these examina bons

hon of the epitheltal lavers with marked infoldine.

*We are grateful to Major Ronald Mloore

MIC

USN tor car

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