Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0007097 (carcinoma)
 152,788 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thyroid tissue of 300 routine autopsies was processed in a standardized manner. So-called solid cell nests (SCN) were found in 21 patients (7%). These cases were investigated carefully by serial step sectioning. In order to explore the correlation of SCN to the C-cell system, the sections were stained by silver impregnation and the immunoperoxidase method. Morphometric analyses revealed a significant increase in the density of C cells in the proximity of the SCN. With progressive distance from the SCN, the C-cell density decreased and reached normal values. In 30% of the cases argyrophilic and calcitonin-positive cells were found lying within the SCN. Occasionally, mixed follicles could be discerned: These were lined on the one side by a multilayered squamous epithelium, on the other side by normal monolayered cubic follicular epithelium, and contained a peculiar granular material. In one case, SCN were associated with intrathyroid portions of the parathyroids and adult adipose tissue, in a second case with adipose tissue only. Most probably SCN are vestiges of the ultimobranchial body and should be interpreted as such, despite the fact that other authors have expressed different views. The lack of disturbances in the calcium metabolism of the patients and the absence of medullary carcinoma in their family histories led us to interpret locally confined C-cell hyperplasia not as reactive nor premalignant, but rather as normal.
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PMID:The relation between solid cell nests and C cells of the thyroid gland: an immunohistochemical and morphometric investigation. 37 83

Twelve cases of medullary thyroid carcinoma were investigated ty the immunoperoxidase method using anti-calcitonin, anti-C-thyroglobulin (C-Tg, C cell-immunoreactive thyroglobulin) and anti-19S thyroglobulin antisera. Tumor cells as well as normal C cells revealed distinct immunoreaction for C-Tg besides for calcitonin. In contrast to normal C cells, the tumor cells were stained more intensely by anti-Ctg antiserum than by anti-calcitonin antiserum. Furthermore, there occurred several tumors or some areas of tumors which showed strong response to anti-C-Tg antiserum but weak or no response to anti-calcitonin antiserum. Thus, medullary carcinoma cells synthesized far greater amounts of C-Tg than calcitonin. The small follicles were occasionally observed mingled in typical cell solid masses. They stored colloid-like materials which were intensely immunoreactive to C-Tg but nonreactive to calcitonin. The specific immunoreaction patterns to anti-C-Tg and anti-calcitonin antisera were also obtained on the ground materials of the amyloid. On the histogenesis of amyloids of medullary carcinoma, the C-Tg could be the presursor of the fibrillar protein of amyloids and the component of the fibrillar protein also closely related to calcitonin.
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PMID:Immunohistochemical study of the medullary thyroid carcinoma with reference to C-thyroglobulin reaction of tumor cells. 38 9

Multiple endocrine neoplasia, type 2b (MEN 2b) is a disorder characterized by C-cell disease of the thyroid gland (medullary carcinoma or C-cell hyperplasia, or both), pheochromocytoma, ganglioneuromatosis, and skeletal and connective tissue abnormalities. The medullary thyroid carcinoma (MTC) is bilateral and multicentric; it metastasizes locally and distally, often before the disease is recognized. Histologically proven C-cell disease was present in 89 of the 107 patients (83%) reported with the condition, including 17 Mayo Clinic patients (average age at diagnosis, 19.2 years). Nineteen of the 107 patients (18%) died of MTC (average age at death, 25.3 years); 9 (8%) succumbed to pheochromocytoma, 7 of these also having metastatic MTC; 13 12%) died of other or unknown causes, but 2 of these had disseminated MTC as well; 29 (27%) survive with metastatic MTC; an additional 21 (20%) are alive, but concentrations of plasma immunoreactive calcitonin (iCT) have not been measured; 6 more (6%), 5 of whom had thyroidectomy before the age of 12 years, are alive with normal plasma concentrations of iCT; and the remaining 10 (9%) have been lost to follow-up. Survival of patients with MEN 2b after operation was reduced when compared with that of a control population -- 80% versus 99% at 5 years and 50% versus 98% at 10 years. The only effective treatment for MTC is total thyroidectomy before metastasis occurs. "Cure" of MTC in patients with MEN 2b has generally been obtained in those having total thyroidectomy before age 12. Therefore, in young patients suspected of having MEN 2b, we recommend prompt evaluation of C-cell function by measurement of stimulated concentrations of iCT and treatment by total thyroidectomy if results are abnormal.
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PMID:C-cell disease of the thyroid gland in multiple endocrine neoplasia, type 2b. 38 10

The authors present the case of a 34-year-old woman with disseminated medullary carcinoma of the thyroid to emphasize the value of calcitonin assay in the diagnosis of this condition despite the absence of a thyroid mass and negative scans. An increased concentration of serum carcino-embryonic antigen was confirmed. The diarrhea associated with the disease did not respond to indomethacin in this patient suggesting that in some cases of medullary carcinoma diarrhea is not due to excessive production of prostaglandins.
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PMID:Diarrhea and medullary carcinoma of the thyroid. 45 72

A case of a highly invasive thyroid carcinoma, which occurred in a 68-year-old woman, was studied by light and electron microscopy, and histochemical and biochemical analysis. Light microscopical, histochemical, and biochemical features were consistent with a diagnosis of a calcitonin-producing, amyloid-rich medullary carcinoma; electron microscopical patterns, mainly the presence of lumina, microvilli, and extensively dilated cytoplasmic E.R., were reminiscent of the ultrastructural features of the follicular carcinoma. Electron-dense bodies interpreted as "secretory granules" were very scarce. This case appears very similar to the case recently presented by Valenta et al. and interpreted as a microfollicular carcinoma. The atypical features of our case of MCT seem to indicate that this tumor should be included in a group of atypical MCT; these should be kept separate from the typical (differentiated) ones on morphological, functional, and prognostic grounds.
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PMID:Medullary carcinoma of the thyroid with atypical patterns. 49 47

Following operation for medullary thyroid carcinoma, elevated serum calcitonin levels were present in 18 patients who had no clinically evident residual tumor. In eight of these patients, additional operations have been performed to achieve an appropriate thyroidectomy and cervical lymph node dissection. In six of these eight, elevated serum calcitonin concentrations persist. Extensive clinical examinations failed to identify a metastatic focus of carcinoma. Serum calcitonin concentrations have remained relatively stable for up to six years (average, 3.9 years) of observations in 12 patients after initial or only operations performed from one to 13 years (average 7.3 years) previously. This suggests that microscopic metastases of this carcinoma can remain relatively dormant for years. The management of medullary thyroid carcinoma requires initially adequate cervical operations, periodic serum calcitonin measurements postoperatively, reoperation if adequate neck surgery has not been performed and if serum calcitonin levels remain elevated and only periodic reevaluation for other asymptomatic patients with persistently elevated concentrations of serum calcitonin.
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PMID:Management of occult medullary thyroid carcinoma: evidenced only by serum calcitonin level elevations after apparently adequate neck operations. 63 6

A correlated light, immunofluorescent, electron and immunoelectron microscopic study on the histogenesis and immunochemical nature of the tumor amyloid in medullary carcinoma of thyroid (MCT) was performed. The light microscopic finding of cytoplasmic inclusions in tumor cells was related ultrastructurally to a unique form of cellular degeneration composed of particulate and fibrillar matters, which could be the precursor of amyloid deposits. The immunofluorescent staining revealed calcitonin in tumor cells and in portions of amyloid. Ultrastructurally, the storage granules were morphologically heterogeneous and contained variable amount of immunoreactive calcitonin. Immunoelectron microscopy demonstrated disintegration of the granules with apparent discharge of calcitonin into the matrix of the above-mentioned particulate and fibrillary mass. Immunoreactive calcitonin was not shown on the mature amyloid fibrils nor in most of the granular matters closely associated with the amyloid. The results indicate that the amyloid in MCT, though related to the secretory products of the tumor cells, may not represent the hormonally active calcitonin molecule.
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PMID:Electron and immunoelectron microscopic study of thyroidal medullary carcinoma. 65 88

As pheochromocytoma sometimes is accompanied by medullary thyroid carcinoma (in the sense of multiple endocrine adonomatosis type II = Sipple-Syndrome), serum calcitonin (CT) was measured by radioimmunoassay in 4 patients with pheochromocytoma. Before extirpation of the adreno-medullary tumor, serum CT was distinctly increased to 3 and 30 ng/ml in 2 of 4 patients, respectively. After removal of the tumor, serum CT was normal in the patients and pentagastrin stimulation produced no exaggerated CT response. In hydrochloric acid extracts from the two corresponding pheochromocytoma tissues, immunoreactive-Calcitonin (IR-CT) was detected, the concentrations amounting 1 and 4 ng/mg wet tissue. These findings suggest that hypercalcitonism in patients with pheochromocytoma cannot always be ascribed to the thyroid, i.e. increased calcitonin levels do not necessarily indicate a medullary carcinoma of this organ.
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PMID:Hypercalcitoninaemia in patients with pheochromocytoma. 67 41

Calcium infusion and pentagastrin injection were compared as tests to stimulate calcitonin secretion for the detection of medullary carcinoma of the thyroid. Plasma concentrations of immunoreactive calcitonin were measured by radioimmunoassay before and during both stimulation tests in 2 persons who had been found at operation to have medullary thyroid carcinoma, 1 relative in whom a cervical lymph node biopsy had shown medullary thyroid carcinoma and 36 asymptomatic relatives. The tests were carried out on separate days by intravenous infusion of calcium gluconate for 2 hours, to provide 3.75 mg/kg of elemental calcium per hour, and rapid intravenous injection of 0.5 microgram/kg of pentagastrin. Before stimulation immunoreactive calcitonin was undetectable in the plasma of 34 of the 36 asymptomatic persons; the 2 with elevated baseline concentrations of the hormone had a positive response to both tests. Seven others showed an increase in plasma immunoreactive calcitonin concentration only after pentagastrin injection. The two persons with initially elevated values and three of the seven with increased values after pentagastrin injection were found at subsequent operation to have focal medullary carcinoma and parafollicular cell hyperplasia; after the operation immunoreactive calcitonin was undetectable in the plasma, even after stimulation. Rapid injection of pentagastrin is more reliable than slow infusion of calcium as a stimulation test for the early detection of medullary thyroid carcinoma.
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PMID:Calcium infusion and pentagastrin injection in diagnosis of medullary thyroid carcinoma. 67 97

To detect familial medullary thyroid carcinoma in a premetastatic stage, we administered tests provocative of calcitonin secretion (infusion of calcium or pentagastrin or both) each year for seven years to members of a pedigree now numbering 107. Since 1970, 21 patients converted from normal to abnormal secretory responses (two separate tests in which calcitonin levels exceeded 0.58 ng per milliliter). Twenty of 21 glands removed showed C-cell hyperplasia, and eight of the 20 also showed foci of carcinoma. As compared to the 12 patients with tumors detected during the first year of screening, all of whom had bilateral carcinoma (seven of 12 with local metastases), later carcinomas were smaller (mean diameter of 0.2 vs. 0.8 cm), were unilateral (in all but two cases) and occurred in younger patients (mean age of 14.9 vs. 36.4 years), and none had detectable metastases.
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PMID:Natural history of familial medullary thyroid carcinoma: effect of a program for early diagnosis. 69 25


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