de Lima M A, Gontijo V A, Schmitt F C
Disciplina de Endocrinologia, Faculdade de Medicina, Triângulo Mineiro, Uberaba, MG, Brasil.
Rev Hosp Clin Fac Med Sao Paulo. 1998 Mar-Apr;53(2):86-90.
This is a report of two cases of congenital goiter in which it was possible to indicate, through immunohistochemistry method, the disorder in the hormonal synthesis. One of these cases was of a sixteen-year-old woman, with goiter since childhood who used thyroid hormone replacement for ten years. Pathology showed coloid goiter with follicular adenoma. Immunohistochemistry showed strong mainly apical follicular cell thyroglobulin. Thyroglobulin was not found in the coloid. This finding is compatible with a malfunction of thyroglobulin exocitosis. The reaction for thyroid peroxidase was adequate for the age. The other case was a 13 year-old-boy with goiter and thyroid hormone replacement since the age of 1 year. He presented slight mental and growth retardation. Pathology showed coloid goiter with follicular adenoma. Immunohistochemistry study showed a very weak and diffuse reaction for thyroid peroxidase while the reaction for thyroglobulin was adequate. These findings indicate quantitative defect of thyroid peroxidase.
本文报告两例先天性甲状腺肿病例,通过免疫组化方法能够指出激素合成方面的紊乱。其中一例为一名16岁女性,自幼患有甲状腺肿,接受甲状腺激素替代治疗10年。病理显示为胶样甲状腺肿伴滤泡性腺瘤。免疫组化显示主要在滤泡细胞顶端有强烈的甲状腺球蛋白反应。在胶质中未发现甲状腺球蛋白。这一发现与甲状腺球蛋白胞吐功能障碍相符。甲状腺过氧化物酶反应与年龄相符。另一例是一名13岁男孩,自1岁起患有甲状腺肿并接受甲状腺激素替代治疗。他有轻微的智力和生长发育迟缓。病理显示为胶样甲状腺肿伴滤泡性腺瘤。免疫组化研究显示甲状腺过氧化物酶反应非常微弱且弥漫,而甲状腺球蛋白反应正常。这些发现表明甲状腺过氧化物酶存在定量缺陷。