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Endocrine Pathology

, Volume 12, Issue 4, pp 437–441 | Cite as

Juvenile rheumatoid arthritis with amyloid goiter: Report of a case with review of the literature

  • Amitabh Srivastava
  • Mukta Baxi
  • Subhash Yadav
  • Amit Agarwal
  • Ramesh K. Gupta
  • Saroj K. Misra
  • Ambrish Mithal
Case Report

Abstract

Clinically significant enlargement of the thyroid owing to amyloid deposition is a rare occurrence. A 23-yr-old female, a case of juvenile rheumatoid arthritis, developed rapidly increasing thyromegaly during the course of her illness with complaints of dyspnea and dysphagia. Thyroid function tests were within normal limits. Fine-needle aspiration cytology proved inconclusive. Total thyroidectomy was done for symptomatic relief with a preoperative clinical impression of malignancy. Histopathologic findings were consistent with amyloid goiter. The findings of this case are presented, to emphasize the difficulties in making a definite preoperative diagnosis, along with a brief review of the literature.

Key Words

Amyloidosis thyroid goiter rheumatoid arthritis 

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References

  1. 1.
    Livolsi VA. Medullary carcinoma In: Bennington JL, ed. Surgical pathology of the thyroid. Philadelphia:WB Saunders, 1990: 213–252.Google Scholar
  2. 2.
    Arean VM, Klein RE. Amyloid goiter: review of the literature and report of a case. Am J Clin Pathol 36:341–355, 1961.PubMedGoogle Scholar
  3. 3.
    Fuller RH. Hamartomatous adiposity with superimposed amyloidosis of the thyroid gland. Am J Clin Pathol 20:188, 189, 1950.PubMedGoogle Scholar
  4. 4.
    Sirsat MV, Jatoi AF. Fatty infiltration in an amyloid goiter. Indian J Pathol Bacteriol 4:39–41, 1961.Google Scholar
  5. 5.
    Hamed G, Heffess CS, Shmookler BM, Wenig BM. Amyloid goiter: a clinicopathologic study of 14 cases and review of literature. Am J Clin Pathol 104:306–312, 1995.PubMedGoogle Scholar
  6. 6.
    Duhra P, Cassar J. Thyroid function tests in amyloid goiter. Postgrad Med J 66:304–306, 1990.PubMedGoogle Scholar
  7. 7.
    Danovitch GM, Le Roith D, Sikuler SE, Straus R. Amyloid goiter in familial Mediterranean fever. Clin Endocrinol (Oxf) 11:595–601, 1979.Google Scholar
  8. 8.
    Kanoh T, Shimada H, Uchino H, Matsumura K. Amyloid goiter with hypothyroidism. Arch Pathol Lab Med 113:542–544, 1989.PubMedGoogle Scholar
  9. 9.
    Rich MW. Hypothyroidism associated with systemic amyloidosis. Head Neck 17:343–345, 1995.PubMedCrossRefGoogle Scholar
  10. 10.
    Alvarez-Sala R, Prados C, Sastre-Marcos J, et al. Amyloid goiter and hypothyroidism secondary to cystic fibrosis. Postgrad Med J 71:307–308, 1995.PubMedGoogle Scholar
  11. 11.
    Kimura H, Yamashita S, Ashizawa K, Yokoyama N, Nagataki S. Thyroid dysfunction in patients with amyloid goiter. Clin Endocrinol (Oxf) 46:769–774, 1997.CrossRefGoogle Scholar
  12. 12.
    Ikenoue H, Okamura K, Kuroda T, Sato K, Yoshinari M, Fujishima M. Thyroid amyloidosis with recurrent subacute thyroiditis-like syndrome. J Clin Endocrinol Metab 67:41–45, 1998.CrossRefGoogle Scholar
  13. 13.
    Kostina ZI. Amyloid goiter in amyloidosis secondary to pulmonary tuberculosis. Probl Tuberk 48:40–44, 1970 (in Russian).PubMedGoogle Scholar
  14. 14.
    D’Antonio A, Franco R, Sparano L, Terzi G, Pettinato G. Amyloid goiter: the first evidence in secondary amyloidosis. Report of five cases and review of literature. Adv Clin Pathol 4:99–106, 2000.Google Scholar
  15. 15.
    Bely M, Apathy A, Pinter T, Ratko J. Generalised secondary amyloidosis in rheumatoid arthritis. Acta Morphol Hung 40:49–69, 1992.PubMedGoogle Scholar
  16. 16.
    Habu S, Watanobe H, Kimura K, Suda T. A case of amyloid goiter secondary to Crohn’s disease. Endocr J 46:179–182, 1999.PubMedGoogle Scholar
  17. 17.
    Greenstein AJ, Sachar DB, Panday AK, et al. Amyloidosis in inflammatory bowel disease: a 50 year experience with 25 patients. Medicine (Baltimore) 71:261–270, 1992.Google Scholar
  18. 18.
    Sbai A, Wechsler B, Leenhardt L, Beaufils H, Hoang C, Menegaux F, Piette JC. Amyloid goiter as the initial manifestation of systemic amyloidosis due to familial Mediterranean fever with homozygous MEFV mutation. Thyroid 11:397–400, 2001.PubMedCrossRefGoogle Scholar
  19. 19.
    Mache CJ, Schwingshandl J, Ring E, Pleger A, Borkenstein MH. Amyloid goiter in a child with familial Mediterranean fever. J Pediatr Endocrinol 7:371, 372, 1994.PubMedGoogle Scholar
  20. 20.
    Samuels MH, Thompson N, Leichty D, Ridgway EC. Amyloid goiter in cystic fibrosis. Thyroid 5:213–215, 1995.PubMedGoogle Scholar
  21. 21.
    Goldsmith JD, Lai ML, Daniele GM, Tomazewski JE, Livolsi VA. Amyloid goiter: report of two cases and review of the literature. Endocr Pract 6:318–323, 2000.PubMedGoogle Scholar
  22. 22.
    Cohan P, Hirrschowitz S, Rao JY, Tanavoli S, Van Herle AJ. Amyloid goiter in a case of systemic amyloidosis secondary to ankylosing spondylitis. J Endocrinol Invest 23:762–764, 2000.PubMedGoogle Scholar
  23. 23.
    Schwarz RE, Dralle H, Linke RP, Nathrath WB, Neumann KH. Amyloid goiter and arthritides after kidney transplantation in a patient with systemic amyloidosis and Muckle-Wells syndrome. Am J Clin Pathol 92:821–825, 1989.PubMedGoogle Scholar
  24. 24.
    Moriuchi A, Yokoyama S, Kashima K, Andoh T, Nakayama J, Noguchi S. Localised primary amyloid tumour of the thyroid developing in the course of Hashimoto’s thyroiditis. Acta Pathol Jpn 42:210–216, 1992.PubMedGoogle Scholar
  25. 25.
    Schmitt TL, Steiner E, Klinger P, Sztankay A, Grubeck-Loebenstein B. The production of an amyloidogenic metabolite of the Alzheimer amyloid beta precursor protein (APP) in thyroid cells is stimulated by interleukin-1 beta but inhibited by interferon gamma. J Clin Endocrinol Metab 81:1666–1669, 1969.CrossRefGoogle Scholar
  26. 26.
    Graebert KS, Popp GM, Kehle T, Herzog V. Regulated O-glycosylation of the Alzheimer beta-A4 amyloid precursor protein in thyrocytes. Eur J Cell Biol 66:39–46, 1995.PubMedGoogle Scholar
  27. 27.
    Lee VW, Rubinow A, Pehrson J, Skinner M, Cohen AS. Amyloid goiter: preoperative scintigraphic diagnosis using Tc-99m pyrophosphate. J Nucl Med 25:468–471, 1984.PubMedGoogle Scholar
  28. 28.
    Miyake H, Maeda H, Isomoto I, Nagatomo H, Nakashima A, Ashizawa A. Computed tomography in amyloid goiter. J Comput Assist Tomogr 12:621, 622, 1988.PubMedCrossRefGoogle Scholar
  29. 29.
    Ishimura E, Okamura T, Masaki H, et al. Amyloid goiter: radiological study in a case presenting with hypothyroidism. Horm Metab Res 28:27–31, 1996.PubMedCrossRefGoogle Scholar
  30. 30.
    el Reshaid K, al-Tamami M, Johny KV, Madda JP, Hashim A. Amyloidosis of the thyroid gland: role of ultrasonography. 22:239–244, 1994.Google Scholar
  31. 31.
    Lucas A, Sanmarti A, Salinas I, Llatjos M, Foz M. Amyloid goiter: diagnosis by fine needle aspiration biopsy of the thyroid. J Endocrinol Invest 12:43–46, 1989.PubMedGoogle Scholar
  32. 32.
    Fontan FJ, Cardido F, Mosquera J, Valbuena L, Atanes A, Amyloid goiter: CT and MR findings. Clin Radiol 50:409–411, 1995.PubMedCrossRefGoogle Scholar
  33. 33.
    Polliack A, Freund V. Mixed papillary and follicular carcinoma of the thyroid gland with stromal amyloid. Am J Clin Pathol 53:592–595, 1970.PubMedGoogle Scholar
  34. 34.
    Valenta LJ, Michele-Bechet M, Mattson JC, Singer FR. Microfollicular thyroid carcinoma with amyloid rich stroma, resembling medulary carcinoma of the thyroid (MCT). Cancer 39:1573–1586, 1977.PubMedCrossRefGoogle Scholar
  35. 35.
    Coli A, Bigotti G, Zuchetti F, Negro F, Massi G. Papillary carcinoma in amyloid goiter. J Exp Clin Cancer Res 19:391–394, 2000.PubMedGoogle Scholar
  36. 36.
    Liftin AJ. Non-medullary carcinoma of the thyroid gland in association with amyloid goiter: case report. Mt Sinai J Med 52:225–227, 1985.PubMedGoogle Scholar
  37. 37.
    van Rijswijk MH, van Heusden CW. The potassium permanganate method: a reliable method for differentiating amyloid AA from other forms of amyloid in routine laboratory practice. Am J Pathol 97:43–58, 1979.PubMedGoogle Scholar
  38. 38.
    Kisilevsky R. Amyloid and amyloidoses: differences, common themes and practical considerations. Mod Pathol 4:514–18, 1991.PubMedGoogle Scholar

Copyright information

© Humana Press Inc 2001

Authors and Affiliations

  • Amitabh Srivastava
    • 1
  • Mukta Baxi
    • 2
  • Subhash Yadav
    • 3
  • Amit Agarwal
    • 2
  • Ramesh K. Gupta
    • 1
  • Saroj K. Misra
    • 2
  • Ambrish Mithal
    • 3
  1. 1.Department of PathologySanjay Gandhi Postgraduate Institute of Medical SciencesLucknowIndia
  2. 2.Department of Endocrine SurgerySanjay Gandhi Postgraduate Institute of Medical SciencesLucknowIndia
  3. 3.Department of Medical EndocrinologySanjay Gandhi Postgraduate Institute of Medical SciencesLucknowIndia

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