Neoplastic and non-neoplastic thyroid lesions in autopsy material: historical review of six decades in São Paulo, Brazil.

AIMS AND BACKGROUND: The aim of the study was to report and discuss a historical series of neoplastic and non-neoplastic lesions of the thyroid gland obtained at autopsy that were examined between 1931 and 1989 at the Pathology Department of the Medical School of the University of São Paulo. METHODS: Records of 145,043 cases were reviewed to select those affecting the thyroid gland. The slides of these selected cases were analyzed and classified according to the current terminology. RESULTS: Non-neoplastic lesions comprised 91.62% of the cases (n = 4647), and most of them were adenomatous goiter (n = 3014). Neoplastic lesions were divided into two groups: primary and metastatic. Of the 282 primary tumors, 135 were benign and 147 were malignant. Among the malignant neoplasms, the most frequent types were follicular, papillary and undifferentiated (n = 39, 36 and 29, respectively). The most frequent tumor types among the metastatic neoplasms were lymphoproliferative processes and carcinomas (n = 67 and 34, respectively). CONCLUSIONS: We conclude that, because of the high frequency of neoplastic lesions (8.38%), 68.24% of which were malignant, detailed examination of the thyroid by pathological methods should be carefully and systematically performed for the accurate detection of thyroid lesions, especially carcinomas.

Thyroid papillary carcinoma lipomatous type: report of two cases.

The authors present two cases of a new variant of papillary carcinoma of the thyroid gland with an unusual lipomatous component. The first case occurred in a 50-year-old woman: the thyroid gland showed lipomatous foci in the stroma of the papillary carcinoma. The second case occurred in a 38-year-old man with the same lipomatous component appearing in small foci. In both cases, the lipomatous tissue was found within the stroma. As far as we known, there are only tree other reports of this type of thyroid gland carcinoma in the literature.

[Incidence of adrenalitis in necropsy material]. / Incidência de adrenalites em material de necropsia.

In the necropsy material of the Medical School of the University of São Paulo, collected between 1931 and 1981, consisting of 131,466 post-mortem examinations, there were 254 (0.2%) cases of adrenalitis, 185 male and 69 female. In 161 of these cases the affection was bilateral, in 46 it was unilateral and in 47 cases this information is lacking. In 111 cases (43.7%), the adrenalitis was caused by tuberculosis, in 86 cases (33.8%), by South American blastomycosis, in three cases (1.2%) by histoplasmosis, in two (0.8%) by Salmonellosis, in two (0.8%) by cytomegalovirus infection and in one (0.4%) by leishmaniasis. The high number of cases with tuberculosis and paracoccidioidomycosis of adrenal glands is due to high incidence of these infections in Brazil.

Study in necropsy material of "cause-specific mortality" in diabetics, in São Paulo-Brasil.

Specific causes of death in diabetic patients was studied in retrospective work from necropsies performed at the Medicine School of the University of São Paulo from 1931 until 1989. From 145,043 necropsies, 813 indexed cases were found: 449 females (55.2%) and 364 males (44.8%). The race ratio of patients was: 584 (71.8%) white, 208 (25.6%) negro and 21 (2.6%) asiatic. The predominant age of death incidence was between the fifth and sixth decades. The main causes reported were infections (42.68%), coma (12.79%), neurologic involvement (11.56%) and cardiac diseases (11.07%); indeterminate causes of death were related in 7.4% of cases. Our results differ from the others of literature mainly in two points: the high prevalence of infectious diseases and the proportional low incidence of cardiopathies. We concluded that, in our casuistic, infectious diseases in diabetic patients represent an important cause of death establishing important clinical parameters for their care.

The prevalence of unsuspected thyroid pathology in 300 sequential autopsies, with special reference to the incidental carcinoma.

Three-hundred whole thyroid glands were collected at autopsy from patients who had no known clinical history of thyroid disease, and who varied from 13 to 82 years of age; 200 were male and 100 female. Thyroid glands were weighed, measured, and examined after previous formalin fixation. Histologic examination was done in 16 areas from both lobes and isthmus, and divided into three levels, anterior, medial, and posterior. All areas suspected of neoplasia macroscopically were identified and studied microscopically; other areas were collected randomly for microscopic examination in the proportion of one fragment per 5 grams of tissue. In all cases both benign and malignant neoplasias were an incidental finding, seen in 6.6% of the cases and with no relation to the patient's main disease. Overall, there were malignant neoplasias in 2.33% but occult carcinoma comprised 1% of the cases. The incidence of other thyroid pathologies, all of them unrelated to the main disease of the patient, are also reported.