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those cases with thyroid nodules, 2 boys with greatestgrowth retardation
developed atrophy of the thyroid gland with signs of hypothyroidism(Fig. 21).
Figure 22 shows the gross appearance of the nodules at surgery.
Note the
varied size of the nodules from several millimeters to several centimeters,
some being cystic, and some hemorrhagic.
Figure 23 shows the microscopic
characteristics of these benign nodules.
They resemble closely adenomatous
goiter usually seen with iodine deficiency and definite radiation effects
were not identified in the glands by most pathologists.
Figure 24 shows
the gross and Figure 25 the microscopic appearance of the mixed papillary
and follicular cancer with. localized metastases that occurred in the woman
referred to above.
It has become increasingly clear that the growth retardation noted in
the children is probably associated with thyroid deficiency, even though a
hypothyroid tendency was not detected in earlier years when the growth
retardation was first noted.
It has since been discovered that a high
level of iodoprotein is normally present in the Marshallese people which
gives a falsely high PBI level (Rall and Conard).
low degree of hormone deficiency.
This may have masked a
However by 11 years after exposure the
2 boys showing the greatest growth retardation developed characteristics
of frank hypothyroidism with atrophy of the thyroid gland, drop in PBI level
to less than 2 yg%, development of coarse facial features, dry skin and
Achilles reflex with sluggish return and bone dysgenesis.
TSH levels indicated a primary hypothyroidism.
High pituitary
Several other children with
less degree of growth retardation have recently shown some degree of thyroid
deficiency also.
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