Histochemical demonstration of thyroxine, triiodothyronine, and thyroglobulin in the primary lesion of thyroid carcinoma, and its predictability for radioiodine uptake by metastatic lesions

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Abstract
Although a total thyroidectomy followed by131I therapy is widely adopted for hematogenous metastatic lesions of thyroid carcinoma, they do not always take up enough131I for treatment. This work was undertaken to elucidate the predictive value of histochemical demonstration of thyroid hormones in the primary lesion for131I uptake by the metastatic lesions. A total of 27 patients with thyroid carcinoma underwent the above treatment during a 19‐year period (1966–1984). Metastases in either the lung, the bone, or both were found in 12, 9, and 6 patients, respectively. Five patients died of thyroid cancer 2, 4, 10, 10, and 20 years after the initial surgery. Five patients demonstrated negative131I uptake in the lung metastases, but one of them had simultaneous bone metastasis, which was positive for131I uptake. Sectioned specimens were stained by the peroxidase antiperoxidase method for thyroxine, triiodothyronine, and thyroglobulin, the presence of which was demonstrated in 15, 9, and 26 cases, respectively. All of the thyroxine‐ or triiodothyronine‐positive patients showed the ability to take up131I.131I uptake was not shown in 4 of 12 thyroxine‐negative or in 4 of 18 triiodothyronine‐negative cases. From these results, it may be concluded that131I uptake by metastatic lesions is predictable when thyroxine or triiodothyronine is demonstrated immunohistochemically in the primary lesion. In the absence of thyroxine or triiodothyronine, however, no prediction can be made.
Funding Information
  • Ministry of Higher Education and Scientific Research (60570606)