RESUMO
Conventional preparation of goitrous hyperthyroid patients using lugol and propranolol may take 2 weeks. This period may be shortened using sodium iopodate and dexamethasone. We used 500 mg of sodium iopodate and 1 mg dexamethasone for 4 days in 34 hyperthyroid patients. Surgical indication derived from failure to medical treatment (68%), large goiter (27%) or adverse reaction to PTU (6%). Clinical euthyroidism was achieved after 4 days in all patients. T3 levels decreased from 482 +/- 26.2 to 137.6 +/- 3.7 ng/dl and T4 from 20.6 +/- 1.04 to 15.2 +/- 0.5 micrograms/dl (p < 0.005). Surgery was uneventful in 33 patients, one subject developed supraventricular tachycardia responsive to verapamil. Electron microscopy of the removed thyroid tissue revealed marked decrease of superficial villi and large phagosomes. Thus, sodium iopodate and dexamethasone are effective and safe for preoperative preparation of hyperthyroid patients.
Assuntos
Dexametasona/uso terapêutico , Hipertireoidismo/cirurgia , Ipodato/uso terapêutico , Cuidados Pré-Operatórios , Adolescente , Adulto , Quimioterapia Combinada , Feminino , Bócio/tratamento farmacológico , Bócio/cirurgia , Humanos , Hipertireoidismo/sangue , Hipertireoidismo/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Tireoidectomia , Tiroxina/sangue , Tri-Iodotironina/sangueRESUMO
Fine needle aspiration cytology (FNAC) has been shown to be second only to surgical biopsy for demonstration of malignancy in thyroid nodules. A prospective study of FNAC for euthyroid uninodular goiter (EUG) was conducted between January 1987 and June 1990, totaling 87 patients of which 61 were submitted to surgical biopsy. FNAC in the latter were interpreted as benign in 41 cases, suspected malignancy in 8, and definitely malignant in 7. The remaining 5 smears were considered technically inadequate for diagnosis. In 39 of the 41 patients with a benign (negative) cytology result, the histopathological diagnosis confirmed the absence of a neoplastic process (2 false negatives). In 12 of the 15 patients with a suspected malignant (positive) cytology result, a subsequent histopathological report confirmed a neoplastic process (3 false positives). Thus FNAC had a sensitivity of 86% and a specificity of 93%. We conclude that FNAC is a valuable tool for the diagnosis of erythroid goiter and could help reduce significantly the number of patients who need to be surgically intervened.
Assuntos
Biópsia por Agulha , Bócio Nodular/patologia , Adolescente , Adulto , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
Fine needloe aspiration cytology (FNAC) has been shown to be second only to surgical biopsy for demonstration of malignancy in thyroid nodules. A prospective study of FNAC for euthyroid uninodular goiter (EUG) was conducted between January 1987 and June 1990, totalizing 87 patients of which 61 were submitted to surgical biopsy. FNAC in the latter were interpreted as benign in 41 cases, suspected malignancy in 8, and definitely malignant in 7. The remaining 5 smears were considered technically inadecuate for diagnosis. In 39 of the 41 patients with a benign (negative- cytology result, the histopathological diagnosis confirmed the absenece of a neoplastic process (2 false negatives). In 12 of the 15 patients with a suspected amloignant (positive) cytology result, a subsequent histopathological report confirmed a neoplastic process (3 false positives). Thus FNAC had a sensitivity of 86% and a specificity of 93%. We conclude that FNAC is a valuable tool for the diagnosis of enthyroid goiter and could help reduce significantly the number of patients who need to be surgically intervened
Assuntos
Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Biópsia por Agulha , Bócio Nodular/patologia , Diagnóstico DiferencialRESUMO
Parotid gland lymphomas are very uncommon. Two patients with this condition were treated in the last decade. Surgery should be used only for diagnosis and becomes unnecessary when adenopathy is present, since a lymph node biopsy will establish the diagnosis.