title: Two cases of Graves' disease with presentation of unilateral diffuse uptake of radioisotopes.
abstract: We present two cases of Graves' disease whose initial thyroidal scintiscan with 99mTcO4- (Case 1) and 123I (Case 2) showed unilateral diffuse uptake of radioisotopes. Initial diagnosis was possibility of malignancy in Case 1 and Graves' disease or Plummer's disease in Case 2. Both cases underwent right hemithyroidectomy. Histopathology of the resected thyroid gland in both showed hyperplastic columnar epithelium and infiltrative lymphocytes which was compatible with Graves' disease. Twenty seven (Case 1) and eight months (Case 2) after operation, both presented with thyrotoxic symptoms associated with enlarged left lobe, increased serum free thyroid hormone concentrations, suppressed TSH concentration, increased thyroidal 123I uptake in the remaining left lobe, and positive thyrotropin receptor antibodies. Both cases were successfully treated with methimazole. It was concluded that initial radioisotope uptake as well as scintigram in rare subgroup of patients with Graves' disease could be similar with that of non-autoimmune autonomous goiter (Plummer's disease).
authors.affiliation: Third Department of Internal Medicine, Gifu University School of Medicine, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Sakata
authors.forename: Y
authors.initials: Y
authors.lastname: Fuwa
authors.forename: S
authors.initials: S
authors.lastname: Goto
authors.forename: M
authors.initials: M
authors.lastname: Fukui
authors.forename: H
authors.initials: H
authors.lastname: Yuasa
authors.forename: H
authors.initials: H
authors.lastname: Takuno
authors.forename: H
authors.initials: H
authors.lastname: Sarui
authors.forename: I
authors.initials: I
authors.lastname: Matsui
authors.forename: T
authors.initials: T
authors.lastname: Ogawa
authors.forename: N
authors.initials: N
authors.lastname: Sasano
mesh_terms: D000818:Animals; D005260:Female; D006111:Graves Disease / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007457:Iodine Radioisotopes; D008713:Methimazole / Q000627:therapeutic use; D051379:Mice; D008875:Middle Aged; D011863:Radioimmunoassay; D011877:Radionuclide Imaging; D013667:Technetium; D013960:Thyroid Function Tests; D013961:Thyroid Gland / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy; D013974:Thyroxine / Q000097:blood; D014284:Triiodothyronine / Q000097:blood
chemical_list: D007457:Iodine Radioisotopes; D014284:Triiodothyronine; D008713:Methimazole; D013667:Technetium; D013974:Thyroxine