ISSN:
1432-2307
Keywords:
Graves' disease
;
Preoperative treatment
;
Ultrastructure
;
Antithyroid drug treatment
;
Lithium
;
Cellular involution
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Summary This electron microscopic study is based on 12 cases of toxic goiter treated preoperatively with iodide, thionamides and lithium. Essential features of Graves' disease include hypertrophy of the follicular epithelium, papillary follicular infoldings and frequently, lymphocytic infiltration and fibrosis. After preoperative therapy most thyroid glands show involutional changes of varying degree with reaccumulation of colloid and flattening of the follicular epithelium. In a small number of histologically examined cases (n=84) colloid goitre (13%) and nodular goitre (8%) were noted. Lymphocytic infiltration and interstitial fibrosis do not show any correlation with preoperative treatment. Ultrastructurally, different stages of cellular involution are seen. The hypertrophic follicular cell shows an increased cell surface with numerous long microvilli and some pseudopodia at the apical border and an occasionally thickened, basal lamina. The cytoplasm contains a well developed system of organelles which synthesizes (rough endoplasmic reticulum, Golgi apparatus, cytoplasmic vesicles) and degrades (colloid droplets, lysosomes) thyroglobulin. With increasing cellular atrophy we found cells to be reduced in size but to contain well developed thyroglobulin-synthesizing organelles. Finally, we observed completely atrophic flat cells with only a few organelles. There are at date no electron microscopic communications on lithiumpretreated thyroid glands. After lithium therapy characteristic changes are observed at the membranes of the cytocavitary system, which are often found to be thin and occasionally to be damaged. The rough endoplasmic reticulum is virtually deprived of ribosomes and the Golgi apparatus seems to be underdeveloped. The number of apical microvilli is reduced. The morphological findings following iodide-, thionamide- and lithium pretreatment in Graves' disease are discussed in light of recent biochemical results.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF01200898
