Analysis of thyroid lesions in childhood recipients after hematopoietic stem cell transplantation

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  • MAEDA Naoko
    Department of Pediatrics, National Hospital Organization Nagoya Medical Center
  • HAMAJIMA Takashi
    Department of Pediatric Endocrinology and Metabolism, Aichi Children's Health and Medical Center
  • YAMBE Yuko
    Department of Endocrinology and Metabolism, National Hospital Organization Nagoya Medical Center
  • SEKIMIZU Masahiro
    Department of Pediatrics, National Hospital Organization Nagoya Medical Center
  • HORIBE Keizo
    Department of Pediatrics, National Hospital Organization Nagoya Medical Center Clinical Research Center, National Hospital Organization Nagoya Medical Center

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Other Title
  • 小児期の造血幹細胞移植後の甲状腺病変についての検討
  • 臨床研究 小児期の造血幹細胞移植後の甲状腺病変についての検討
  • リンショウ ケンキュウ ショウニキ ノ ゾウケツ カンサイボウ イショク ゴ ノ コウジョウセン ビョウヘン ニ ツイテ ノ ケントウ

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Abstract

We performed a physical examination and ultrasonography of the thyroid gland in 24 patients who had received hematopoietic stem cell transplantation with a total-body irradiation (TBI)-containing regimen during childhood. When ultrasonography revealed thyroid nodules larger than 1 cm in diameter, fine-needle aspiration biopsies were performed. Of 5 patients with palpable masses and thyroid nodules larger than 1 cm, adenomatous goiter was diagnosed in 4 cases and thyroid cancer in 1. Of the remaining 19 patients in whom no palpable mass was detected in the physical examination, 5 had thyroid nodules (including 1 adenomatous goiter), 6 had cystic lesions, and 8 exhibited no abnormalities on ultrasonography. No significant differences in sex, age at transplantation, interval between transplantation and evaluation, primary disease, preconditioning regimen, status at transplantation, stem cell source, chronic graft-versus-host disease, hypogonadism, or hypothyroidism were observed between patients with and without nodules. Individuals who received hematopoietic stem cell transplantation with a TBI-containing regimen are at risk of secondary thyroid cancer due to radiotherapy and require regular clinical evaluations of the thyroid gland by palpation, and ultrasonography should be incorporated into these checkups.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 54 (3), 263-268, 2013

    The Japanese Society of Hematology

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