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Nagasaki K, Minamitani K, Nakamura A, Kobayashi H, Numakura C, Itoh M, Mushimoto Y, Fujikura K, Fukushi M, Tajima T. Guidelines for Newborn Screening of Congenital Hypothyroidism (2021 Revision). Clin Pediatr Endocrinol 2022; 32:26-51. [PMID: 36761493 PMCID: PMC9887297 DOI: 10.1297/cpe.2022-0063] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/06/2022] [Indexed: 12/04/2022] Open
Abstract
Purpose of developing the guidelines: Newborn screening (NBS) for congenital hypothyroidism (CH) was started in 1979 in Japan, and early diagnosis and treatment improved the intelligence prognosis of CH patients. The incidence of CH was once about one in 5,000-8,000 births, but has been increased with diagnosis of subclinical CH. The disease requires continuous treatment and specialized medical facilities should conduct differential diagnosis and treatment in patients who are positive by NBS to avoid unnecessary treatment. The Guidelines for Mass Screening of Congenital Hypothyroidism (1998 version) were developed by the Mass Screening Committee of the Japanese Society for Pediatric Endocrinology in 1998. Subsequently, the guidelines were revised in 2014. Here, we have added minor revisions to the 2014 version to include the most recent findings. Target disease/conditions: Primary congenital hypothyroidism. Users of the Guidelines: Physician specialists in pediatric endocrinology, pediatric specialists, physicians referring pediatric practitioners, general physicians, laboratory technicians in charge of mass screening, and patients.
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Affiliation(s)
- Keisuke Nagasaki
- Mass Screening Committee, Japanese Society for Pediatric Endocrinology
- Thyroid Committee, Japanese Society for Pediatric Endocrinology
- Division of Pediatrics, Department of Homeostatic Regulation and Development, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kanshi Minamitani
- Thyroid Committee, Japanese Society for Pediatric Endocrinology
- Department of Pediatrics, Teikyo University Chiba Medical Center, Chiba, Japan
| | - Akie Nakamura
- Mass Screening Committee, Japanese Society for Pediatric Endocrinology
- Department of Pediatrics, Hokkaido University School of Medicine, Sapporo, Japan
| | - Hironori Kobayashi
- Mass Screening Committee, Japanese Society for Pediatric Endocrinology
- Laboratories Division, Shimane University Hospital, Izumo, Japan
| | - Chikahiko Numakura
- Mass Screening Committee, Japanese Society for Pediatric Endocrinology
- Department of Pediatrics, Yamagata University School of Medicine, Yamagata, Japan
| | - Masatsune Itoh
- Thyroid Committee, Japanese Society for Pediatric Endocrinology
- Department of Pediatrics, Kanazawa Medical University, Kanazawa, Japan
| | - Yuichi Mushimoto
- Thyroid Committee, Japanese Society for Pediatric Endocrinology
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kaori Fujikura
- Japanese Society for Neonatal Screening
- Sapporo City Institute of Public Health, Sapporo, Japan
| | - Masaru Fukushi
- Japanese Society for Neonatal Screening
- Sapporo Immuno Diagnostic Laboratory (IDL), Sapporo, Japan
| | - Toshihiro Tajima
- Mass Screening Committee, Japanese Society for Pediatric Endocrinology
- Department of Pediatrics, Jichi Medical University Tochigi Children's Medical Center, Tochigi, Japan
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Qi Y, Liu J, Liu Y, Shen Z, Hu N. Ectopic papillary thyroid carcinoma mimicking distant metastatic tissue. J Int Med Res 2022; 50:3000605221121968. [PMID: 36129883 PMCID: PMC9511341 DOI: 10.1177/03000605221121968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We report a case of a 50-year-old woman presenting with a solid nodule in each lung. She was previously suspected of having lung cancer and distant pulmonary metastasis on the basis of imaging findings. Surgical pathology revealed that the left lung nodule was adenocarcinoma, but the contralateral nodule was papillary thyroid carcinoma (PTC). We subsequently performed total thyroidectomy, and the histological findings of the resected specimen showed no suspicious tumor tissue. Overall, the results led to a diagnosis of ectopic intrapulmonary PTC with synchronous lung adenocarcinoma. Ectopic intrapulmonary PTC is a rare but true phenomenon that may be easily mistaken for pulmonary metastasis in daily practice. It is important to improve the recognition of ectopic intrapulmonary thyroid tumors to avoid misdiagnosis.
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Affiliation(s)
- Yingsong Qi
- Department of Cardiothoracic Surgery, Chengde Central Hospital, No. 11 Guangren Road, Chengde, Hebei, People’s Republic of China
- Yingsong Qi, Department of Cardiothoracic Surgery, Chengde Central Hospital, No. 11 Guangren Road, Chengde, Hebei 067000, People’s Republic of China.
| | - Jianwei Liu
- Department of Cardiothoracic Surgery, Chengde Central Hospital, No. 11 Guangren Road, Chengde, Hebei, People’s Republic of China
| | - Ya Liu
- Department of Nephrology, Affiliated Hospital of Chengde Medical College, No. 36 Nanyingzi Street, Chengde, Hebei, People’s Republic of China
| | - Zhihua Shen
- Department of Pathology, Chengde Central Hospital, No. 11 Guangren Road, Chengde, Hebei, People’s Republic of China
| | - Na Hu
- Deparatment of Medical Imaging, Chengde Central Hospital, No. 11 Guangren Road, Chengde, Hebei, People’s Republic of China
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Kumar J, Karna R, Srividya BT, Prakash A, Singh I, Garg A. Ectopic Thyroid Tissue in Submandibular Region. MAMC JOURNAL OF MEDICAL SCIENCES 2019. [DOI: 10.4103/mamcjms.mamcjms_18_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Gu T, Lu YL, Han B, Jiang BR, Wang LZ, Yang LZ, Han YS. Ectopic thyroids have lower computed tomography attenuation values than orthotopic thyroids. Endocrine 2018; 62:546-551. [PMID: 30203122 DOI: 10.1007/s12020-018-1747-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 09/03/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE To determine whether ectopic thyroid had the same computed tomography (CT) value as orthotopic thyroid. METHODS Twenty-one patients with 23 ectopic thyroids and 23 controls with orthotopic thyroids underwent CT scans and were included in this retrospective study. The CT images were reviewed in a blinded fashion by two radiologists. Independent-Samples T-test was used for comparison of CT attenuation values between two groups. RESULTS Ectopic thyroids had significantly lower non-enhanced attenuation (91.04 ± 5.97 Hounsfield Units vs. 106.56 ± 4.06 Hounsfield Units, P = 0.038) and contrast-enhanced attenuation (141.32 ± 6.42 Hounsfield Units vs. 169.82 ± 4.30 Hounsfield Units, P = 0.001) values than orthotopic thyroids. CONCLUSIONS Ectopic thyroids have lower CT attenuation values than orthotopic thyroids probably due to the structural or functional abnormalities. The dysgenesis and pathological changes of the ectopic thyroids may contribute to functional deficiency which finally leads to decrease of the CT attenuation values.
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Affiliation(s)
- Ting Gu
- Division of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ying-Li Lu
- Division of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Bing Han
- Division of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Bo-Ren Jiang
- Division of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Li-Zhen Wang
- Department of Oral Pathology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Li-Zhen Yang
- Division of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
| | - Yong-Shun Han
- Department of Radiology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
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Xu F, Shao Z, Yang G, Gu A, Jiang M, Pan Y, Ma Y. The value of scintigraphy, computed tomography, magnetic resonance imaging, and single-photon emission computed tomography/computed tomography for the diagnosis of ectopic thyroid in the head and neck: A STROBE-compliant retrospective study. Medicine (Baltimore) 2018; 97:e0239. [PMID: 29595677 PMCID: PMC5895372 DOI: 10.1097/md.0000000000010239] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Because of its rarity, the exact imaging features of ectopic thyroid are poorly known.To analyze the value of scintigraphy, computed tomography (CT), magnetic resonance imaging (MRI), and single-photon emission computed tomography (SPECT)/CT in the diagnosis of ectopic thyroid in the head and neck.First, we retrospectively analyzed the scintigraphy, CT, MRI, and SPECT/CT images from 25 masses (22 patients) suspected of head and neck ectopic thyroid from 2006 to 2017 at the Shanghai Ninth People's Hospital. Each mass was imaged by nuclear imaging (scintigraphy with or without SPECT/CT) and radiological exam (CT and/or MRI). Pathological examination was considered as the gold standard. Secondly, thirteen malignant ectopic thyroids in the head and neck reported in the English literature from 2001 to 2017 were retrieved for comparison.The accuracy of scintigraphy was not significantly higher than that of CT (94.7%, vs 89.5%, P > .99) or MRI (92.3%, vs 84.6%, P > .99). Five masses which underwent scintigraphy with SPECT/CT were all true positive, while 1 was false negative on MRI, and 2 were false negative on CT. Compared to the benign ectopic thyroids in our study, the 13 malignant ectopic thyroids retrieved from the literature were grossly the same in shape, margins, and invasion on CT or MRI.The number of patients was limited, but scintigraphy combined with SPECT/CT could be a reliable method for the diagnosis of ectopic thyroid. Benign and malignant ectopic thyroids appear to be similar in shapes, margins, and invasion on CT or MRI.
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Affiliation(s)
- Feng Xu
- Department of Nuclear Medicine
| | - Ziyang Shao
- Department of Oral & Maxillofacial - Head & Neck Oncology
| | - Gongxing Yang
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | | | - Mengda Jiang
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | | | - Yubo Ma
- Department of Nuclear Medicine
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Nagasaki K, Minamitani K, Anzo M, Adachi M, Ishii T, Onigata K, Kusuda S, Harada S, Horikawa R, Minagawa M, Mizuno H, Yamakami Y, Fukushi M, Tajima T. Guidelines for Mass Screening of Congenital Hypothyroidism (2014 revision). Clin Pediatr Endocrinol 2015; 24:107-33. [PMID: 26594093 PMCID: PMC4639532 DOI: 10.1297/cpe.24.107] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Accepted: 03/24/2015] [Indexed: 12/31/2022] Open
Abstract
Purpose of developing the guidelines: Mass screening for congenital hypothyroidism
started in 1979 in Japan, and the prognosis for intelligence has been improved by early
diagnosis and treatment. The incidence was about 1/4000 of the birth population, but it
has increased due to diagnosis of subclinical congenital hypothyroidism. The disease
requires continuous treatment, and specialized medical facilities should make a
differential diagnosis and treat subjects who are positive in mass screening to avoid
unnecessary treatment. The Guidelines for Mass Screening of Congenital Hypothyroidism
(1998 version) were developed by the Mass Screening Committee of the Japanese Society for
Pediatric Endocrinology in 1998. Subsequently, new findings on prognosis and problems in
the adult phase have emerged. Based on these new findings, the 1998 guidelines were
revised in the current document (hereinafter referred to as the Guidelines). Target
disease/conditions: Primary congenital hypothyroidism. Users of the Guidelines: Physician
specialists in pediatric endocrinology, pediatric specialists, physicians referring
patients to pediatric practitioners, general physicians, laboratory technicians in charge
of mass screening, and patients.
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Affiliation(s)
| | | | | | - Keisuke Nagasaki
- Division of Pediatrics, Department of Homeostatic Regulation and Development, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kanshi Minamitani
- Department of Pediatrics, Teikyo University Chiba Medical Center, Chiba, Japa
| | - Makoto Anzo
- Department of Pediatrics, Kawasaki City Hospital, Kawasaki, Japan
| | - Masanori Adachi
- Department of Endocrinology and Metabolism, Kanagawa Children's Medical Center, Kanagawa, Japan
| | - Tomohiro Ishii
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Kazumichi Onigata
- Shimane University Hospital Postgraduate Clinical Training Center, Shimane, Japan
| | - Satoshi Kusuda
- Maternal and Perinatal Center, Tokyo Women's Medical University, Tokyo, Japan
| | - Shohei Harada
- Division of Neonatal Screening, National Center for Child Health and Development, Tokyo, Japan
| | - Reiko Horikawa
- Department of Endocrinology and Metabolism, National Center for Child Health and Development, Tokyo, Japan
| | - Masanori Minagawa
- Division of Pediatrics, Department of Homeostatic Regulation and Development, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Haruo Mizuno
- Departments of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yuji Yamakami
- Kanagawa Health Service Association, Kanagawa, Japan
| | | | - Toshihiro Tajima
- Department of Pediatrics, Hokkaido University School of Medicine, Sapporo, Japan
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Abstract
BACKGROUND Ectopic intrapulmonary thyroid is extremely rare, with only about two cases reported in the literature. These cases were found either during the work-up of a solitary pulmonary nodule or at autopsy. Here, we report a case of ectopic intrapulmonary thyroid mimicking multiple pulmonary metastases from an endometrioid adenocarcinoma of the uterus. PATIENT FINDINGS A 50-year-old woman presented with dysmenorrhea and menorrhagia. Endometrial curettage of the uterus revealed an endometrioid adenocarcinoma. During the staging, multiple pulmonary nodules were found. To exclude the possibility of lung metastases of the endometrioid adenocarcinoma from the uterus, video-assisted thoracic surgery (VATS) with wedge resection was performed for the largest nodule. The histopathology for that nodule was entirely consistent with normal thyroid tissue. The patient underwent surgery for uterine cancer and was discharged without further adjuvant chemotherapy. The remaining intrapulmonary nodules were unchanged in size on a serial computed tomography scan. SUMMARY In this patient, pulmonary metastases were initially considered the most likely cause of the multiple pulmonary nodules, but the diagnosis of the ectopic intrapulmonary thyroid was ultimately made based on VATS-wedge resection for the largest pulmonary nodule. The patient was able to avoid any unnecessary systemic chemotherapy. CONCLUSIONS Ectopic intrapulmonary thyroid is extremely rare but can be confused with pulmonary metastases from other sites. We are unaware of similar cases in the literature.
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Affiliation(s)
- Han Suk Ryu
- Department of Pathology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
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Maki AC, Foster MB, Bond SJ. Lateral pediatric ectopic thyroid. Laryngoscope 2012; 123:524-7. [DOI: 10.1002/lary.23359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 03/15/2012] [Accepted: 03/26/2012] [Indexed: 11/08/2022]
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