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| |  ARRS: Thymic Hyperplasia Common in Patients with Metastatic Thyroid Cancer By Emma Hitt Special to DG News ATLANTA, GA -- May 2, 2002 -- About a third of patients undergoing treatment for metastatic thyroid cancer appear to have thymic hyperplasia, which could result in unnecessary biopsies. Dr. Eric R. Niendorf, of the Beth Israel Deaconess Medical Center, Boston, Massachusetts, presented the findings here Wednesday at the 102nd annual meeting of the American Roentgen Ray Society (ARRS). "In our patients with thyroid cancer undergoing thoracic CT [computed tomography], there seemed to be an increased incidence of thymic hyperplasia," said Dr. Niendorf tin an interview with Doctor’s Guide. "So we wanted to identify the prevalence and also thymic morphologic features in these patients." Dr. Niendorf and colleagues point out that benign thymic hyperplasia may be a potential cause of false-positive CT scans and unnecessary radioiodine studies, because it may be mistaken for a thymic mass. In this study, the researchers identified 57 thyroid cancer patients (22 men and 35 women, aged 24 to 91) who underwent spiral CT of the thorax for evaluation of metastatic disease. Two observers reviewed each scan for the presence of thymic hyperplasia, defined as a gland for which at least two of three parameters (width, length, attenuation) were greater than two standard deviations above published values for normal age-adjusted control groups. The thymus gland was identified on CT scans in 24 (42 percent) of the 57 patients. In these patients, the average right and left lobe thickness and length values were significantly greater than those reported for controls. Nineteen (33 percent) of the 24 patients met criteria for thymic hyperplasia. Seven (29 percent) had superior mediastinal activity, identified by iodine-131 whole body scans. Thymic hyperplasia "typically appears as an enlarged gland that maintains a normal pyramidal configuration," the researchers note. "A familiarity with this characteristic appearance should help to prevent false-positive diagnoses and avoid unnecessary biopsy procedures." According to Niendorf, the shape of the gland can help identify thymic hyperplasia, but "if necessary, the patient can undergo a radioiodine scan to help exclude metastatic disease".
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