Indian Journal of Nuclear Medicine
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Year : 2006  |  Volume : 21  |  Issue : 3  |  Page : 50-55

Thyroid ectopia in hyperthyroidism

Nuclear Medicine, Mandakini Nuclear Imaging Centre, Mumbai, India

Correspondence Address:
Aban M Samuel
Nuclear Medicine Consultant, Mandakini Imaging Center, Mumbai-400 077
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Source of Support: None, Conflict of Interest: None

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Aims: Analyse the frequency and sites of ectopic thyroid tissue detected during scintimaging of the hyperthyroid gland. Materials and methods: 190 consecutive scintimages of hyperthyroid glands were analysed. Dynamic flow and perfusion studies, Technetium-99m pertechnetate (Tc-99m04-) thyroid uptake and static images were obtained in the anterior RAO and LAO views along with a marker view to establish landmarks at the sterna notch and any palpable nodules. Results: Hyperthyroid glands showed Tc-99m04- uptake values ranging from 3% to over 30%. 87% of the glands were diffuse goiters while the remaining were due to Plummers disease or autonomous hot nodules. The size of the glands showed a mild to moderate enlargement with the longest length of the lobes being 5-7 cms. Ectopic tissue in the form of pyramidal lobe, thyroglossal tract, lingual, sublingual or substernal sites were noted. 44% of patients with elevated thyroid uptakes and a diffuse enlargement of the gland showed the presence of ectopic thyroid tissues. Of these, single ectopic sites was present in 78% of cases while the remaining showed dual and one case triple site of ectopia. There was no correlation of the presence of ectopia with size of gland enlargement, %thyroid uptake, clinical severity of the hyperthyroidism or the presence of antimicrosomal or antithyroglobulin antibodies. No thyroid stimulating immunoglobulin assays were done in our patients, however reports strongly suggest the association of detection of ectopic tissue with the presence of thyroid stimulating immunoglobulins in Graves disease and hyperthyroidism. Conclusions: It is therefore proposed that in the case of unavailability of assays for thyroid stimulating thyroid antibodies in Graves disease the detection of ectopic tissue can be used as a marker for Graves disease.

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