Nikiforov Y E, Heffess C S, Korzenko A V, Fagin J A, Gnepp D R
Department of Pathology, Minsk Medical Institute, Belarus.
Cancer. 1995 Sep 1;76(5):900-9. doi: 10.1002/1097-0142(19950901)76:5<900::aid-cncr2820760527>3.0.co;2-x.
In addition to the previously reported increase in incidence of thyroid carcinomas in Belarussian children after the Chernobyl disaster in April, 1986, benign thyroid lesions were also found to be increased in the exposed population.
A total of 60 follicular neoplasms and benign nonneoplastic thyroid lesions arising after the Chernobyl disaster in children and adolescents of 7 to 18 years of age were studied.
The primary diagnoses in this series were follicular carcinoma in 1 (2%) case, follicular adenoma in 9 (15%), cystic adenomatoid nodule with papillae in 18 (30%), multinodular goiter in 18 (30%), diffuse hyperplasia in 2 (3%), diffuse hyperplasia with atypia and nodularity in 5 (8%), lymphocytic thyroiditis in 6 (10%), and thyroid cyst in 1 patient (2%). Additional histologic changes in thyroid glands from these patients were similar to those reported after radiation exposure, and included perifollicular fibrosis (72%), focal epithelial hyperplasia (73%), colloid accumulation (47%), follicular atrophy (33%), and cellular atypia (25%). Vascular abnormalities were found more often (75%) than previously reported in the thyroid gland after irradiation, and had a somewhat different appearance. They affected primarily medium-size arteries and were characterized by damage of the internal elastic lamina in addition to intimal fibrosis.
The first case of thyroid follicular carcinoma in the exposed Belarussian children was diagnosed after a latent period of 6.5 years, as compared with 4 years of minimal latency for post-Chernobyl papillary carcinomas. Among benign thyroid lesions, cystic adenomatoid nodules of papillary type and diffuse hyperplasia with cellular atypia and nodularity seem to be commonly associated with radiation exposure to the thyroid gland.
除先前报道的1986年4月切尔诺贝利灾难后白俄罗斯儿童甲状腺癌发病率增加外，还发现受辐射人群的良性甲状腺病变也有所增加。
对7至18岁儿童及青少年在切尔诺贝利灾难后出现的60例滤泡性肿瘤和良性非肿瘤性甲状腺病变进行了研究。
该系列病例的初步诊断为：滤泡癌1例（2%），滤泡性腺瘤9例（15%），乳头状囊性腺瘤样结节18例（30%），多结节性甲状腺肿18例（30%），弥漫性增生2例（3%），伴有异型性和结节性的弥漫性增生5例（8%），淋巴细胞性甲状腺炎6例（10%），甲状腺囊肿1例（2%）。这些患者甲状腺的其他组织学变化与辐射暴露后报道的相似，包括滤泡周围纤维化（72%）、局灶性上皮增生（73%）、胶质积聚（47%）、滤泡萎缩（33%）和细胞异型性（25%）。血管异常的发现频率（75%）高于先前报道的辐射后甲状腺，且外观有所不同。它们主要影响中等大小动脉，其特征除内膜纤维化外，还有内弹性膜损伤。
白俄罗斯受辐射儿童中的首例甲状腺滤泡癌在潜伏期6.5年后被诊断，而切尔诺贝利事故后乳头状癌的最短潜伏期为4年。在良性甲状腺病变中，乳头状囊性腺瘤样结节以及伴有细胞异型性和结节性的弥漫性增生似乎与甲状腺的辐射暴露密切相关。
