Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ninety-one patients with histologically proven anaplastic carcinoma of the thyroid were referred to the Beatson Oncology Centre between 1961 and 1986. The female:male ratio was 2.4:1 and the median age at presentation was 70 (range 38-92) years. All patients had a thyroid mass at presentation and the most common symptoms were dyspnoea, dysphagia and dysphonia. Five patients had a total thyroidectomy and 28 partial thyroidectomy. Ninety five per cent of patients received external beam radiotherapy. Results show dyspnoea to be the only symptom strongly influencing survival. Total or partial thyroidectomy is associated with increased survival. This association is most marked for patients presenting without dyspnoea. Eighty per cent of patients responded to radiotherapy.
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PMID:Anaplastic thyroid carcinoma: 91 patients treated by surgery and radiotherapy. 158 15

This study reviews 21 cases of thyroid lymphoma diagnosed between 1969 and 1980. The thyroid gland was the primary site in all but two cases. The 20 patients with non-Hodgkin lymphoma had a mean age of 66 years, 75% were women, and all were Caucasian. A rapidly growing thyroid mass with hoarseness, dysphagia, and difficulty in breathing was the initial finding. Most patients had diffuse histiocytic lymphomas. Associated Hashimoto thyroiditis was found histologically in 57% of the cases. Using the immunoperoxidase stain method on tissue sections, intracytoplasmic monoclonal immunoglobulin was demonstrated in 5 of 15 cases. All but two patients received radiation therapy, and 13 received chemotherapy. The median survival was 8 months; 20% died of unrelated causes and 32% are alive (average duration: 27 months). Dissemination, after local control by radiation therapy, was the leading cause of death. The prognosis was better in men, in patients under the age of 65 years, and in those patients who, on biopsy, did not have involvement of the extrathyroid soft tissue or regional lymph nodes.
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PMID:Malignant lymphoma of the thyroid gland: a clinicopathologic study. 704 44

The clinical and pathologic spectrum of lymphoproliferative disorders affecting the thyroid is diverse and must be differentiated from benign thyroiditis and carcinoma. The clinical presentations include an enlarging neck mass, but patients may also present with symptoms of dysphagia, hoarseness and choking, or a cold thyroid nodule. The histopathologic interpretation requires adequate tissue sampling and proper pathologic interpretation. The recent delineation of new pathological entities such as low-grade malignant lymphoma of mucosa-associated lymphoid tissue (MALT) type has aided in the understanding of the clinical course and management of patients with lymphoma. Advances have been made in the clinical management and treatment of these disorders. Surgical resection of the thyroid mass is not routinely part of the management strategy. The management of low-grade lymphoproliferative disorders of MALT type may include radiation therapy, oral chlorambucil, or intravenous chemotherapy (cyclophosphamide, vincristine, and prednisone). The management of diffuse large B-cell lymphoma is combined-modality therapy with radiation and cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy.
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PMID:Primary thyroid lymphoma. 1037 88

Plasma cell granuloma involving the thyroid is very rare. A 29-year-old man with type 1 diabetes mellitus presented with a one-week history of fever, sore throat, neck tenderness and dysphagia. Antibiotics were given but over the next two weeks a hard 8 cm mass in the left lobe of the thyroid developed. Fine needle aspiration was not diagnostic and surgical exploration revealed an inflammatory process arising from the left lobe of the thyroid involving the left sternothyroid muscle and parapharyngeal spaces. Histology of multiple biopsies showed plasma cell granuloma. Immunoperoxidase staining demonstrated the presence of IgG, IgM and IgA with predominance of IgG. The residual mass resolved and was impalpable after four weeks. Plasma cell granuloma should be suspected when there is a rapidly developing hard thyroid mass. Open biopsy/removal and histological confirmation are mandatory and residual disease may resolve within weeks.
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PMID:A hard thyroid mass due to plasma cell granuloma. 1145 84

A patient with invasive fibrous thyroiditis (Riedel's thyroiditis), dysphagia, and bilateral lacrimal gland involvement is described. Resolution of the thyroid mass and orbital swellings followed corticosteroid therapy. The unusual ocular features of this case are briefly discussed and the use of corticosteroid and other immunosuppressant therapy in multifocal fibrosclerosis is reviewed.
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PMID:Multifocal fibrosclerosis: a case of thyroiditis and bilateral lacrimal gland involvement. 1218 7

Metastasis to the thyroid occur infrequently. The overall incidence in autopsy series vary from 0-5% in unselected cases to 24% in patients with a known malignancy. They usually occur when there are another metastases, sometimes many years after diagnosis of the original primary tumour. We present the case of a woman with dysphagia and dysphonia due to a thyroid mass as first manifestation of a metastatic breast cancer.
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PMID:Dysphagia and dysphonia in a woman with a previous breast cancer. 1687 May 43

Thyroid hemorrhage is a relatively frequent event that in most cases causes pain and discomfort only, while rarely can cause significant neck swelling. Even more rarely, however, extensive thyroid hemorrhage can result in a rapidly expanding hematoma with airway compromise. We report a case of a rapidly expanding thyroid hemorrhage that occurred secondary to oral anticoagulation therapy in an 80-year-old patient with a previously existing goiter. The patient presented with acute onset of neck pain, dysphagia, and respiratory distress caused by tracheal compression from the thyroid mass. Computed tomography demonstrated a 6 x 9 x 10 cm mass consistent with an intrathyroidal hematoma projecting into the anterior mediastinum and displacing the trachea to the left. Rapid reversal of the coagulopathy was achieved with fresh frozen plasma and vitamin K. Consequently, the patient was managed conservatively with close observation, antibiotics, and steroids because no progression of airway compromise was manifested. Although the diagnosis can be easily established in these patients, no management guidelines of this condition exist. The potential of rapid airway compromise and the risk for exacerbation of bleeding in the light of significant elevation in the international normalized ratio (INR), make any airway management decisions very difficult. The importance of managing the airway and the haemostatic problem with the help of a multidisciplinary team is discussed.
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PMID:Huge intrathyroidal hematoma causing airway obstruction: a multidisciplinary challenge. 1691 Aug 84

We report a rare event of old hemorrhage into a thyroid causing respiratory distress. A 67-year-old man with chronic cough and recent dysphagia was found to have a retrosternal mass extending into the visceral mediastinum on chest roentgenogram. A computed tomographic (CT) scan confirmed eggshell callcification, which was 53 x 53 x 80 mm in size a retrosternal thyroid mass and revealed significant tracheal deviation to the right due to an extensive mass surrounded by a calcificated capsule in the left lobe of the thyroid gland with extension to the upper mediastinum. He successfully underwent left lobectomy of the thyroid gland with sternotomy. The pathological examination revealed intrathyroidal hemorrhage of the thyroid gland with massive intracystic old bleeding.
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PMID:Eggshell calcification after intrathyroidal hemorrhage of retrosternal thyroid. 1857 51

Riedel's thyroiditis is a rare variant of thyroiditis and characterized by the replacement of thyroid parenchyma by extensive fibrosis. Typically, the thyroid is diffusely involved and a painless, hard anterior neck mass shows clinical features similar to those of anaplastic thyroid carcinoma: a rapidly enlarging, hard, fixed thyroid mass and symptoms such as dysphagia, dysphonia, and dyspnea. We experienced a case of Riedel's thyroiditis that had presented rapidly growing, hard, fixed, thyroid mass mimicking anaplastic thyroid cancer in a 41-year-old female patient with longstanding benign thyroid nodule for 6 years. The clinical features were indistinguishable from that of anaplastic transformation and open biopsy could exclude anaplastic thyroid cancer. After surgery final diagnosis of Riedel's thyroiditis could be made by typical microscopic findings and immunohistochemical studies. We reported the case with review of the related literatures.
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PMID:A case of Riedel's thyroiditis associated with benign nodule: mimic of anaplastic transformation. 1905 28

Papillary carcinoma of thyroid usually presents as a palpable thyroid mass. This could be associated with pain, hoarseness, stridor or dysphagia. Rarely, it presents solely as cervical lympadenopthy in the presence of an otherwise grossly normal thyroid gland. This could pose management problems. We report here a middle-aged lady who presented with cervical lymphadenopathy which on fine needle aspiration cytology was confirmed as metastatic papillary thyroid carcinoma. The thyroid gland was, however, normal on clinical examination and radiological investigations. Neck exploration confirmed a grossly normal thyroid gland; however, the cervical lymph node was found to invade the internal jugular vein. She underwent a total thyroidectomy and unilateral functional block dissection with resection of the involved segment of the internal jugular vein. Histopathology confirmed metastasis in the lymph node and a 2mm sized microcarcinoma in the resected thyroid gland. A radioactive iodine scan in the postoperative period revealed no other metastasis. The patient was prescribed lifelong thyroxine. She is on regular follow-up and 4 years following surgery continues to do well.
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PMID:Papillary Carcinoma of the Thyroid Presenting Primarily as Cervical Lymphadenopathy: An approach to management. 2150 19


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