W. H. ADAMS: LATE MEDICAL CONSEQUENCES OF EXPOSURE TO RADIOACTIVE expert panel of pathologists, are listed in Table 6. Not included is a benign nodule diagnosis in 1989 in a Utirik man. Most benign nodules andall the thyroid carcinomas have occurred in females. “Adenomatous nodules” are included in the tabulation even though it is highly debatable that they are true neoplasms. “Occult papillary carcinomas,” also tabulated, are, with rare exceptions, harmless tumors. A recently reported autopsy series from Germanyindicated occult papillary thyroid carcinomas were present in 6.2% of cases. Since there was no predilection for age it was concluded, as in earlier studies, that occult papillary carcinomas have no propensity to cause clinically apparent thyroid disease. However, there is some evidence that the occurrence of these small tumors maybe increased following radiation exposure. No mortality has been attributable to thyroid cancer in the exposed Marshallese. Most thyroid cancers, including those that are radiation-induced, ate of the papillary variety. The mortality of Table 6 Thyroid nodules diagnosed at surgery through 1989 Adenomatous nodules Adenomas Papillary cancers Follicular cancers Occult cancers Rongelap (67)* 17 2 5 - 1 Ailingnae (19)* 4 - - - 1 Utirik (167)* Comparison (227)** 12 4 4 1 4 2 1*** - 6 Zeer Not Included are the following unoperated (and therefore unconfirmed) nodules: Rongelap - 1; Ailingnae - 1; Utirik - 1; Comparison - 5. Includedare ail consensus diagnoses of a panel of consultant pathologists, two different lesions were detected in one person form Rongelap, one form Ailingnae, and 3 from Utirik. * Numberofpersons(including those in utero) who were originally exposed. **® This numberincludes all persons who have been in the Comparison group since 1957. Some have not been seen for many years; others were added as recently as 1976. Equally divided opinion in one case, follicular carcinomavs. atypical adenoma Majority opinion in one case; occult papillary carcinomavs. follicular carcinoma. The *** **** samepatient had lymphocytic thyroiditis. 282