Coincidental Thyroid Pathologies in Forensic Autopsies
DOI:
https://doi.org/10.17986/blm.2014192793Keywords:
thyroid, forensic autopsy, histopathology, coincidental lesionAbstract
Objectives: It's known that thyroid hyperplasia is one of the most common coincidental lesion of the thyroid gland and microcarcinomas can be seen in autopsies. In our study, it is aimed to investigate the frequencies of thyroid lesions in adult and child cases whose autopsies were performed for medicolegal assessment, in our region. The importance of autopsies was assessed to express the role of thyroid diseases as a cause or promote of death. Besides, thyroid diseases mostly seen in our region and coincidental thyroid pathologies mostly seen in autopsies were compared and discussed.
Method: In this study, it was planned to getting thyroid gland samples prospectively from cases whose autopsies were made in İnstitution of İzmir Forensic Medicine Morgue Speciality Department between April 2009 - April 2010. During the study, thyroid samples from 210 non-putrefied cases were obtained. Age, gender, causes of death, manner of death, weight and morphology of thyroid gland, thyroid pathologies were evaluated. Data were analysed using SPSS software (Version 11.0 for Windows)
Findings: The cases included in the study were 161 men and 49 women. The mean age was 49.44 ± 18.25. The mean weight of thyroid gland was estimated as 40.71±27.95 gram and thyroid lesions were determined in 96 cases on histopathological examination. The prevalence of thyroid pathologies in autopsies was 45 %, the iodine intake is commonly accepted as enough in our region. There was a slight significant correlation between the gland weight and age, there wasn’t any significant correlation between the gland weight and gender. The most common lesions were nodular hyperplasia (29.5%), lenfocytic thyroiditis (5.7%) and hashimoto thyroiditis (5.7%). Metastatic small cell lung carcinoma was identified in one case and congenital epithelial cyst (branchial cyst) was detected in another case.
Conclusion: Examination of thyroid glands routinely at forensic autopsies, not only would be useful in determining the cause of death, but also will contribute to the social health data by yielding the profile of hidden thyroid diseases and especially thyroid malignancies.
Key Words: Thyroid, forensic autopsy, histopathology, coincidental lesion.
Downloads
References
Özyılmaz F, Azmak D, Altaner Ş, Şeker V, Kutlu Ak. Adli otopsilerde doğal ölüm nedenlerinin araştırılması (1984-1997). Patoloji Bülteni Bulletin of Pathology 2001; 18 (1): 7-9.
Davies L, Welch HG. Current thyroid cancer trends in the United States: JAMA Otolaryngol Head Neck Surg. 2014;140(4):317-322. DOI: https://doi.org/10.1001/jamaoto.2014.1
GrandMaison GL, Durigon M. Sudden adult death: a medicolegal series of 77 cases between 1995 and 2000. Medicine Science and the Law. 2002;42(3):225-232. DOI: https://doi.org/10.1177/002580240204200306
Burton EC, Troxclair DA, Newman WP. Autopsy diagnoses of malignant neoplasms. How often are clinical diagnoses incorrect? JAMA 1998;14(280):1245-1248. DOI: https://doi.org/10.1001/jama.280.14.1245
Solares CA, Penalonzo MA, Xu M, Orellana E. Occult papillary thyroid carcinoma in postmortem species: prevalence at autopsy. Am J Otolaryngol. 2005;26(2): 87-90. DOI: https://doi.org/10.1016/j.amjoto.2004.08.003
Bondeson L, Ljungberg O. Occult papillary thyroid carcinoma in the young and the aged. Cancer. 1984 15;53(8): 1790-1792. DOI: https://doi.org/10.1002/1097-0142(19840415)53:8<1790::AID-CNCR2820530831>3.0.CO;2-9
Pakiş I, Karayel F, Turan AA, Koç S, İnanıcı MA. 1998-2002 yılları arasında İstanbulda erişkin otopsilerinin histopatolojik incelemesi. Van Tıp Fakültesi Dergisi. 2008;15(1):1-6.
Fleischmann A, Hardmeier T. [A normal thyroid gland upon autopsy: a relatively uncommon finding]. Schweiz Med Wochenschr. 1999 12;129(23): 873-882.
Vestergaard V, Drostrup DH, Thomsen JL. Sudden unexpected death associated with lymphocytic thyroiditis. Med Sci Law. 2007;47(2): 125-133. DOI: https://doi.org/10.1258/rsmmsl.47.2.125
Edston E. Three sudden deaths in men associated with undiagnosed chronic thyroiditis. Int J Legal Med. 1996;109(2): 94-97. DOI: https://doi.org/10.1007/BF01355524
Akyildiz EÜ, Özaslan A, Tolgay E, Özdeş T, Koç S, Çelik S. Medikolegal otopsilerde malign tümörler. Adli Tıp Dergisi 2006;3:89-93.
Sipos JA, Mazzaferri EL. Thyroid cancer epidemiology and prognostic variables. Clin Oncol (R Coll Radiol). 2010;22(6):395-404. DOI: https://doi.org/10.1016/j.clon.2010.05.004
Hundahl SA, Fleming ID, Fremgen AM, Menck HR. A National Cancer Data Base report on 53,856 cases of thyroid carcinoma treated in the U.S., 1985-1995 [see commetns]. Cancer. 1998 15;83(12): 2638-2648. DOI: https://doi.org/10.1002/(SICI)1097-0142(19981215)83:12<2638::AID-CNCR31>3.0.CO;2-1
Bradly DP, Reddy V, Prinz RA, Gattuso P. Incidental papillary carcinoma in patients treated surgically for benign thyroid diseases. Surgery. 2009;146(6): 1099-1104. DOI: https://doi.org/10.1016/j.surg.2009.09.025
Stio F, Battisti G, Felici A, Franco P, Iavarone C, Marigliani M, Maceroni M, Brescia A. [Thyroid cancer and its incidence in nodular thyroid diseases: our experience]. G Chir. 1990 ;11(9): 487-490.
Harach HR, Williams ED. Childhood thyroid cancer in England and Wales. Br J Cancer. 1995;72(3): 777-783. DOI: https://doi.org/10.1038/bjc.1995.410
Leboulleux S, Hartl D, Baudin E, Schlumberger M. [Differentiated thyroid cancer in childhood]. Bull Cancer. 2012;99(11):1093-1099. DOI: https://doi.org/10.1684/bdc.2012.1645
Vollmer RT. Revisiting overdiagnosis and fatality in thyroid cancer. Am J Clin Pathol. 2014;141(1): 128-132. DOI: https://doi.org/10.1309/AJCP9TBSMWZVYPRR
Bisi H, Fernandes VS, Rosalinda Y, De Camargo A, Longatto Filho A, Ruggeri GB, Abdo AH. Neoplastic and non-neoplastic thyroid lesions in surgical material: historical review of five decades in São Paulo, Brazil. Tumori. 1995;81(1): 63-66. DOI: https://doi.org/10.1177/030089169508100115
Lang W, Borrusch H, Bauer L. Occult carcinomas of the thyroid. Evaluation of 1,020 sequential autopsies. Am J Clin Pathol. 1988;90(1): 72-76. DOI: https://doi.org/10.1093/ajcp/90.1.72
Avetisian IL, Petrova GV. Latent thyroid pathology in residents of Kiev, Ukraine J Environ Pathol Toxicol Oncol. 1996;15(2-4):239-243.
Autelitano F, Santeusanio G, Mauriello A, Autelitano M, Palmieri G, Orlandi A, Spagnoli LG. Latent pathology of the thyroid: an epidemiological and statistical study of thyroids sampled during 507 consecutive autopsies. Ann Ital Chir. 1992 Nov-Dec;63(6):761-781.
Bisi H, Fernandes VS, de Camargo RY, Koch L, Abdo AH, de Brito T. The prevalence of unsuspected thyroid pathology in 300 sequential autopsies, with special reference to the incidental carcinoma. Cancer. 1989 Nov 1;64(9):1888-1893. DOI: https://doi.org/10.1002/1097-0142(19891101)64:9<1888::AID-CNCR2820640922>3.0.CO;2-C
Mandal R, Loeffler AG, Salamat S, Fritsch MK. Organ weight changes associated with body mass index determined from a medical autopsy population. Am J Forensic Med Pathol. 2012;33(4):382-389. DOI: https://doi.org/10.1097/PAF.0b013e3182518e5f
Carlini M, Giovannini C, Mercadante E, Castaldi F, Dell'Avanzato R, Zazza S. [Incidental thyroid microcarcinoma in benign thyroid disease. Incidence in a total of 100 consecutive thyroidectomies]. Chir Ital. 2006;58(4):441-447.
de Matos PS, Ferreira AP, Ward LS. Prevalence of papillary microcarcinoma of the thyroid in Brazilian autopsy and surgical series. Endocr Pathol. 2006;17(2):165-173. DOI: https://doi.org/10.1385/EP:17:2:165
Furmanchuk AW, Roussak N, Ruchti C. Occult thyroid carcinomas in the region of Minsk, Belarus. An autopsy study of 215 patients. Histopathology. 1993;23(4): 319-325. DOI: https://doi.org/10.1111/j.1365-2559.1993.tb01214.x
Yamamoto Y, Maeda T, Izumi K, Otsuka H. Occult papillary carcinoma of the thyroid. A study of 408 autopsy cases. Cancer. 1990 1;65(5):1173-1179. DOI: https://doi.org/10.1002/1097-0142(19900301)65:5<1173::AID-CNCR2820650524>3.0.CO;2-2
Downloads
Published
Issue
Section
License
The Journal and content of this website is licensed under the terms of the Creative Commons Attribution (CC BY) License. The Creative Commons Attribution License (CC BY) allows users to copy, distribute and transmit an article, adapt the article and make commercial use of the article. The CC BY license permits commercial and non-commercial re-use of an open access article, as long as the author is properly attributed.
