Other Benign Pathologies
- Dyshormonogensis
- Ectopic thyroid tissue
123I Perchlorate Discharge Study in Dyshormonogenesis
SA dob: 21/03/92
Goitre + borderline increase in TSH, but normal FT4.
Iodine uptake problem; 10y on 3 x 200mg tablets
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Patients presenting with swellings of the thyroid may have dyshormonogenesis, that is a familial absence or impaired production of one of the enzymes required for hormone production.
A 123 I Iodine scan will show uptake into the thyroid, but the enzyme deficiency will result in a failure of organification of the iodine. When perchlorate is administered IV, the non organified iodine will be discharged from the gland and the counts in the thyroid region will fall by more than 20% of the total counts.
Lingual Thyroid and Thyroglossal cyst
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Mal descent of the thyroid during embryonic development may lead to a ‘lingual’ thyroid.
The 99mTc scan will show the functioning thyroid tissue in the base of the tongue. Midline swellings may occur due to a cyst in the thyroglossal duct. These can become painful if infected. They should be removed as papillary carcinoma may develop in the small rests of thyroid cells that these cysts sometimes contain.
