from Hemorrhage into Thyroid Adenoma'

Hemorrhage into a large follicular adenoma of the thyroid increased a pa tient's serum-protein-bound iodine ( PBI) level to more than twice the normal value. Moreover, radioiodine studies showed a much diminished 1311uptake. The patient was restless, had tachycardia, a fine digital tremor, and a high basal metabolic rate. Since she had not taken iodine-containing drugs or iodine containing radiographic contrast media, these findings probably reflected tempo rarily increased levels of circulating thyroid hormone and temporarily decreased hormonal biosynthesis ( 1, 2, 3,). CASE REPORT This well-developed, 41-year-old spinster entered the hospital because of a large, firm tumor in the right lobe of the thyroid gland. She had noticed a mass in the right side of the neck about six weeks before. Three weeks later the mass suddenly enlarged and became tender. Except for recurrent urticaria she had been in good health. Her weight, 131 pounds, had not varied appreciably during the past five years. She had not taken iodine-containing drugs or iodine-containing radiographic contrast media. In the hospital the temperature ranged between 98 and 98.6 degrees F. oral; the pulse rate, between 84 and 120 beats per minute. The blood pressure was 135/80 mm Mercury. The hemoglobin was 13.1 /100 ml.; the hematocrit, 41 per cent. The white blood cell count was 6300, with a differential count of 61 per cent neutrophils, 31 per cent lymphocytes, and 8 per cent monocytes. The total serum cholesterol was 185 mg/l00 ml. An electrocardiogram was interpreted as suggestive of hyperthyroidism (Fig 1)