Dual Tracer

Follow up CT, MRI, or PET scans are employed to determine the size of the tumor, the extent of local invasion, and if distant metastasis has already occurred11. This is particularly important because, although all ATC cases are considered Stage IV cancers, the severity of metastasis dictates the course of treatment. Stage IVA cancers are limited to the thyroid and are often treated with surgical resection, if possible. This is followed by radiotherapy and chemotherapy9,11. For most patients, however, the cancer is unresectable. As such, clinicians typically shift their focus towards a combination of radiation therapy, chemotherapy, and palliative care to improve the quality of

If the gland appears to be enlarged, the physician may order further tests to diagnose or rule out cancer. These tests include: a CT scan or ultrasonography. The ultrasound uses high-frequency sound waves that are emitted and received by a transducer that is passed over the neck region. The sound waves penetrate the body, and by electronic readings, the sound waves are arranged on a computer screen into a picture image of the thyroid gland and any tumors (Thackery 1058). Another test used is the thyroid scan. A patient is given radioactive iodine to drink. After the iodine has been absorbed by the thyroid, the patient must lie on his or her back with the neck region positioned under a scanner. The information received by the scanner is then sent to a computer that displays a 2-dimensional image of the thyroid used to identify areas in the thyroid that do not absorb iodine normally (Surks 165). The most accurate diagnostic tool for thyroid cancer is biopsy. The test is done in a hospital operating room under a general anesthesia. A sedative is usually given by an injection about one hour before the procedure. A small incision is made in the neck, and either side of the thyroid or the entire lump is removed. The sample is sent to a laboratory to be examined. If thyroid cancer is detected, the thyroid is removed (Shin 420).

Most thyroid tumors can be readily diagnosed using histopathologic criteria, which allow the pathologist to differentiate benign from malignant lesions and guarantee an accurate classification for the majority of the variants of carcinomas derived from follicular epithelial cells. However, in most cases, the pathologist is confronted with thyroid lesions in which the distinction between benign and malignant can be quite subtle. The decision favoring one or another has clinical consequences and implies different modalities of treatment. For this reason, the approach to these challenging tumors should include ancillary techniques, immunohistochemistry and molecular profiling, that can improve the standard morphologic assessment (3).

Hyperparathyroidism is an excess of parathyroid hormone in the bloodstream due to overactivity of one or more of the body's four parathyroid glands. These glands are about the size of a grain of rice and are located in your neck. The parathyroid glands make parathyroid hormone, which helps sustain a suitable balance of calcium in the bloodstream and in tissues that depend on calcium for good functioning. Two types of hyperparathyroidism exist. In primary hyperparathyroidism, an increase of one or more of the parathyroid glands causes overproduction of the hormone, developing in high levels of calcium in the blood (hypercalcemia), which can cause a variety of health problems. Surgery is the most common treatment for primary hyperparathyroidism. Secondary hyperparathyroidism happens as a result of additional disease that primarily causes low levels of calcium in the body and over time, increased

Hyperthyroidism , part of the endocrine system, is a the gland that makes hormones that controls the way every cell in the body uses energy. Your thyroid is located in the front of your neck where the collarbones meet. Having this disease can affect some vital signs. Having hyperthyroidism can cause heart palpitations and high blood pressure. Therefore, because of having this disease, blood pressure and pulse need to be checked and documented every visit. It is important to collect vital signs and note them because it could help diagnose a patient.

At this time, it is not clear how much diagnostic radiation is contributing to the increase in thyroid cancer cases. It is possible that the increase in the diagnosis of thyroid cancer can be attributed to a greater rate of detection by use of ultrasonography and fine needle aspiration3. The thyroid tissue itself is among the tissues that are less sensitive to radiation, however, thyroid cancer is still such a concern because the thyroid is so superficial in the body1 (77). “Even doses as small as 50–100 mGy have been associated with an increased risk of thyroid malignancy in children, with a

After removal of the thyroid gland, patients can undergo radiographic scintigraphy in the nuclear medicine department to obtain functional and anatomical information. Imaging the patient after the administration of I-123 or I-131 can identify precise locations of radioactivity in the entire body, which can identify distant metastases or any remaining thyroid tissue. The size and location of radioactivity can influence whether doctors chooses surgical excision, radioactive iodine therapy (RAI), or external radiation therapy for those areas. Planar imaging has a sensitivity of 41%, specificity of 68%, and an accuracy of 61% compared to SPECT imaging having rates of 45%, 89%, and 78%. With the combining of SPECT/CT,

Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland Medical Center, Baltimore, MD, USA

The parathyroid glands are right behind your thyroid gland in your neck. These glands help your body control the calcium level in the blood.

1997). The glands are composed of chief and oxyphil cells; both cells types contain PTH has a half-life from 4-10 minutes due to rapid degradation in the liver (Aron et al. 1997). Parathyroid hormone provides a powerful mechanism for controlling extracellular Ca and phosphate concentrations by regulating intestinal re-absorption, renal excretion, and exchange between the extracellular fluid and bone of these ions (Aron et al. 1997). Parathyroid hormone response to a decrease in blood Ca levels (Bhattacharya 2014). Serum Ca levels normally average 9.5mg/dL (Kierszenbaum 2007). When Ca intake or absorption is inadequate, PTH is secreted to avoid hypocalcemia by increasing the conversion of 25(OH)vitamin D into 1,25(OH)2vitamin D and intestinal absorption, increasing the renal tubular Ca reabsorption but also increasing bone resorption (Bagchi, Nair ,and Sen 2013). Parathyroid hormone has biphasic effects on bone formation by causing an acute inhibition of collagen synthesis with high concentrations, but, on the contrary, it increases bone formation with prolonged intermittent administration (Rissanen 2013). If the stimulus persists, secondary hyperparathyroidism will cause negative bone balance (Holick

A lot of the conditions discussed above can be treated, or even prevented, if regular tests are done to monitor the gland. Some of the routine tests that health care providers can use to check the functionality of the gland are TSH test, T4 tests, T3 test, thyroid-stimulating immunoglobulin (TSI) test, and the antithyroid antibody test (also called the thyroid peroxidase antibody test (TPOab)). All of these tests are blood tests and depending on if the patient is showing any symptoms of thyroid dysfunction, the health care provider may order more than one of these tests to be

Primary hyperparathyroidism (Option E) is usually due to a solitary adenoma (~85% of cases) or hyperplasia of the parathyroid glands but in 20% of patients may be associated with Paget’s disease. Patients are usually asymptomatic with elevated serum Calcium on routine tests. If they are symptomatic it is usually related to hypercalcemia – polyuria, polydipsia, confusion etc. Lab Tests will show: ↑Ca2+, ↑PTH (or inappropriately normal), ↓Phosphate, ↑ alk Phos.

Still, it is important to immediately identify and address thyroid problems, so you should talk to your doctor if you are experiencing any of these symptoms. Thyroid cancer can sometimes be detected by a fine needle aspiration (FNA) biopsy. At times, the disease is diagnosed once the thyroid is extracted and examined under the microscope. Risk factors linked to thyroid cancer are limited to iodine deficiency, a history of radiation to the head and neck, and family history of endocrine tumor syndrome.

4. State how hyperthyroidism affects each of the following and describe the mechanism by which this change occurs.

According to Wenig (2008), primary hyperparathyroidism (PHPT) is characterised by increased concentrations of parathyroid hormone (PHT), causing calcium levels in the blood to rapidly increase. Leppert and Howard (1997) state that PHPT rarely occurs in pregnant women, presenting 8 per 100,000 cases a year. Despite this, the condition can lead to severe pre-natal and post-natal complications (Leppert and Howard, 1997), such as: the development of hypoparathyroidism in the foetus, hypercalcaemia and the formation of kidney stones (Belfort, 2010).