We report a rare case of radioactive iodine (RAI)-induced Graves' disease in a patient with toxic adenoma. A 42-year-old woman presented with neck masses. A hot nodule was detected on a thyroid scan, which suggested toxic adenoma. She was treated with RAI. Three months after the treatment, she complained of thyrotoxic symptoms such as weight loss, palpitation, diarrhea, and menstrual irregularity. A new thyroid scan showed diffuse increased uptake, while the toxic adenoma previously detected was now a cold nodule. Moreover, an increased level of antibodies against the thyroid-stimulating hormone receptor was detected. These findings indicated Graves' disease. Hence she was treated with anti-thyroid drug. This case serves as a reminder for physicians to consider RAI-induced Graves' disease if thyrotoxicosis is noted after RAI treatment.
Adenoma* ; Adult ; Antibodies ; Diarrhea ; Female ; Graves Disease* ; Humans ; Iodine ; Neck ; Radioisotopes ; Thyroid Gland ; Thyroid Nodule ; Thyrotoxicosis ; Thyrotropin ; Weight Loss

BACKGROUND: The intraoperative parathyroid hormone (IOPTH) assay is widely used in patients with primary hyperparathyroidism (PHPT). We investigated the usefulness of the IOPTH assay in Korean patients with PHPT. METHODS: We retrospectively reviewed the data of 33 patients with PHPT who underwent parathyroidectomy. Neck ultrasonography (US) and 99mTc-sestamibi scintigraphy (MIBI scan) were performed preoperatively and IOPTH assays were conducted. RESULTS: The sensitivity of neck US and MIBI scans were 91% and 94%, respectively. A 50% decrease in parathyroid hormone (PTH) levels 10 minutes after excision of the parathyroid gland was obtained in 91% (30/33) of patients and operative success was achieved in 97% (32/33) of patients. The IOPTH assay was 91% true-positive, 3% true-negative, 0% false-positive, and 6% false-negative. The overall accuracy of the IOPTH assay was 94%. In five cases with discordant neck US and MIBI scan results, a sufficient decrease in IOPTH levels helped the surgeon confirm the complete excision of the parathyroid gland with no additional neck exploration. CONCLUSION: The IOPTH assay is an accurate tool for localizing hyperfunctioning parathyroid glands and is helpful for evaluating cases with discordant neck US and MIBI scan results.
Humans ; Hyperparathyroidism, Primary* ; Neck ; Parathyroid Glands ; Parathyroid Hormone* ; Parathyroid Neoplasms ; Parathyroidectomy ; Radionuclide Imaging ; Retrospective Studies ; Technetium Tc 99m Sestamibi ; Ultrasonography

Nodular lymphoid hyperplasia (NLH) is a benign lymphoproliferative disease that can affect the lung. Because of its rarity, little is known about the etiology and natural history of NLH. Most cases are usually asymptomatic and found incidentally on imaging studies. Imaging finding of NLH has shown most commonly as a solitary lesion, although multifocal pulmonary nodules may be seen. Surgical resection has proved curative in the cases previously described. We report a rare case of NLH in a 55 year-old man who presented with bilateral multiple pulmonary nodules on chest radiography. Open biopsy was performed from the upper and lower lobe of the left lung. The lesions were pathologically diagnosed as pulmonary NLH. Multifocal residual nodules in both lungs remain stable without spontaneous regression during the 3 years of follow-up.
Biopsy ; Follow-Up Studies ; Hyperplasia* ; Lung* ; Lymphoproliferative Disorders ; Multiple Pulmonary Nodules ; Natural History ; Pseudolymphoma ; Radiography ; Thorax

Nodular lymphoid hyperplasia (NLH) is a benign lymphoproliferative disease that can affect the lung. Because of its rarity, little is known about the etiology and natural history of NLH. Most cases are usually asymptomatic and found incidentally on imaging studies. Imaging finding of NLH has shown most commonly as a solitary lesion, although multifocal pulmonary nodules may be seen. Surgical resection has proved curative in the cases previously described. We report a rare case of NLH in a 55 year-old man who presented with bilateral multiple pulmonary nodules on chest radiography. Open biopsy was performed from the upper and lower lobe of the left lung. The lesions were pathologically diagnosed as pulmonary NLH. Multifocal residual nodules in both lungs remain stable without spontaneous regression during the 3 years of follow-up.
Biopsy ; Follow-Up Studies ; Hyperplasia ; Lung ; Lymphoproliferative Disorders ; Multiple Pulmonary Nodules ; Natural History ; Pseudolymphoma ; Radiography ; Thorax