PATIENT NO, 2 (continued)
Laboratory and X-Ray Data: Thyroid Workup: PBI 6.2 .g%, iodine fractionation,
total I 7.1 wet, thyronine fraction (T4+T3) 4.2 ~g%.
Cholesterol 167 mg%, with
143 mg% esters. Thyroid autoantibodies titer under 1:16.
BMR -23%. Thyroid

scan (79%Pc) showed possible nodularity of the right lobe, and to a lesser

32

extent of the lower lobe.
Chest x-ray showed no diseases or abnormalities.
1 I
uptake study showed an uptake of 39% at 6 hours.
PBI 5.4. Following TSH stimulation for three days, the uptake showed a siight decrease at 5-1/2 hours over
the value before TSH stimulation.
Electrocardiogram normal;

sed rate slightly elevated

(21 mm).

Blood

count within normal limits except slightly low RBC (4,100,000) and hemoglobin
12.7 gm. Alkaline phosphatase was slightly low (4.5 units). Total proteins
slightly elevated (8.5 gm with globulins up to 4.5 gm). These are typical
values for Marshallese people. Normal values were found for prothrombin time,
bilirubin, cephalin flocculation, transaminase, calcium, P, thymol turbidity,
FBS, BUN, C02, Cl,
negative,

Na, K.

Urinalysis and stools for ova and parasites were both

Hospital Course;
The patient's hospital course here was uneventful, and he was
transferred to New England Baptist Hospital, Boston, for surgical exploration of
his neck on July 5.
Dr. Bentley P. Colecock, under general anesthesia, removed
a 1.2 cm diameter nodule from the right lobe of the thyroid gland, inciuding
some surrounding thyroid tissue which contained multiple small nodules.
The
nodules varied in color from pale gray to deep red. From histological examination of the tissues, a pathological diagnosis of adenomatous goiter was made.
His recovery from the operation was rapid and subsequent course was uneventful.
He was returned to this hospital on 7-13-65 and was discharged on 7-18-65, fit
to travel back to the Marshall Islands.
Diagnosis:

Adenomatous goiter.

Discharge Medication:
No immediate drug therapy.
It is anticipated that he
will be put on thyroid 180 mg daily for life in September along with the other
exposed Rongelap people.
Follow-lp: Patient has remained in good health and apparently euthyroid on 3
mg levothyroxine daily.
In March, 1966, he was taken off thyroid therapy for
three weeks for test purposes. At that time he showed good thyroidal function
by i327 uptake though his TSH level was slightly elevated (26 mug/ml). No
recurrence of nodules has been noted.
PATIENT NO.
20

AGE
18

SEX
M

HOSPITAL
Hospital of Medical Research Center, BNL

DATE
June, 1965

This 18 year old Marshallese male was admitted to this Hospital for evaluation
of a thyroid nodule which was discovered during this past March.
History of Present Illness:

During the annual physical examination in March, 1965,

this 18 year old boy was found to have a small 1 cm nodule of the right

lobe of

the thyroid gland. He was one of the group of 64 people who had been accidentally
exposed to fallout in 1954.
It was estimated that he had received a whole body

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