1/10. hypopigmentation of a papillary carcinoma arising in a black thyroid.We report a case of an unpigmented papillary carcinoma arising in a black thyroid induced by minocycline. Black thyroid syndrome is an unusual pigmented change seen almost exclusively in patients on minocycline, apparently resulting from an oxidative interaction between thyroid peroxidase and the drug. Twenty-six cases have previously been reported in the English literature, nine of which described an associated thyroid neoplasm. Four of these nine neoplasms were described as pale or hypopigmented. The nature of the lesion against the background of pigmentation suggests diminished function of the thyroid peroxidase in this clonal population.- - - - - - - - - - ranking = 1keywords = black (Clic here for more details about this article) |
2/10. Histologic, immunohistochemical, and ultrastructural findings in a case of minocycline-associated "black thyroid".We report on a 37-yr-old woman with known antemortem ingestion of minocyclin who died suddenly from a ruptured cerebral aneurysm. At autopsy, her thyroid gland, although not enlarged, was diffusely black, caused by the deposition of a melanin-like pigment that stained positive with Schmorl's reagent. The pigment could be bleached with permanganate, and on examination by electron microscopy, it appeared to be deposited within the thyrocyte lysosomes. Additional immunostaining with many antibodies revealed an increase in vimentin staining in the follicular epithelium compared with normal control thyroid glands. Staining for cytoplasmic thyroglobulin was markedly reduced, despite normal thyroid indices performed on stored antemortem blood. Stainable ubiquitin in the follicular epithelium appeared reduced compared with control thyroid tissues. These immunohistochemical findings may reflect disruptions of lysosomal transport and function associated with the abnormal accumulation of pigment. This appears to be the only case of minocyclin-associated "black thyroid" in which extensive immunohistochemical investigations have been performed.- - - - - - - - - - ranking = 1.2keywords = black (Clic here for more details about this article) |
3/10. Is the black thyroid really an innocuous pathological finding?We report the case of a 24-year-old euthyroid woman in whom the discovery of a cold nodule in the left thyroid lobe led to a thyroidectomy. The surgical specimen was characterized by a diffuse black discoloration. Optical examination revealed brown granules within the apical portion of the follicular cells whereas ultrastructural studies showed intralysosomal lipofuscin-like deposits, all findings consistent with pathological descriptions reported in black thyroids associated with the intake of minocycline. Retrospectively, we were told that the patient had received this antibiotic for at least three years for the treatment of acne vulgaris. As experimental models have demonstrated potential antithyroid effects of the drug, it appears relevant to monitor thyroid tests in patients receiving long-term minocycline therapy.- - - - - - - - - - ranking = 1.2keywords = black (Clic here for more details about this article) |
4/10. Giant mitochondria and intramitochondrial inclusions in benign thyroid lesions.Enlarged mitochondria and intramitochondrial dense structures have been reported to occur in a great variety of animal and human cells under normal, pathologic, and experimental conditions. Three cases of benign thyroid lesions are described in which large cytoplasmic inclusions were seen on light microscopy. These inclusions were stained with toluidine blue but not with sudan black B, as was seen in consecutive sections. Ultrastructural observation showed that they corresponded to giant mitochondria. Bundles of dense filaments and round, electron-dense bodies were observed in the matrix of the enlarged mitochondria. Incubation of ultrathin sections with proteolytic enzymes (pepsin, trypsin, and type XVI-protease) led to a striking decrease in the electron density of both types of intramitochondrial matrical structures. These observations demonstrate that a major proteic component exists in intramitochondrial filamentous bundles and in dense bodies.- - - - - - - - - - ranking = 0.2keywords = black (Clic here for more details about this article) |
5/10. Nonpigmented papillary carcinoma in a black thyroid gland.A case of papillary thyroid carcinoma occurring in a 27-year-old man with black thyroid syndrome is reported. The tumor, in contrast to the remaining thyroid, was not pigmented. The significance and potential utility of the differential pigmentation are discussed.- - - - - - - - - - ranking = 1keywords = black (Clic here for more details about this article) |
6/10. Black thyroid: clinical manifestations, ultrastructural findings, and possible mechanisms.Ultrastructural examination of three black thyroid glands showed lysosomal accumulations of lipofuscin-like pigment and granular electron-dense material in association with 1) a minocycline-associated black thyroid with normal thyroid function; 2) a minocycline-associated black thyroid with a significant inflammatory component, fibrosis, and primary hypothyroidism; and 3) a black thyroid gland with no exposure to minocycline. The deposition of the pigments in the three cases resulted in macroscopically recognizable black thyroid glands. It is speculated that an imbalance in lysosomal function accounts for this abnormality. The glandular hypofunction documented in case 2 is unique and confirms the need to monitor function carefully in patients who are receiving minocycline. In one case electrondense deposits were identified in the thyroid gland interstitium.- - - - - - - - - - ranking = 1keywords = black (Clic here for more details about this article) |
7/10. The black thyroid. Its relation to minocycline use in man.We studied a patient with a grossly black thyroid gland considered to be related to minocycline therapy. Microscopically, a brown granular pigment was localized in follicular cells and colloid, which histochemically was melanin or a melaninlike substance. Ultrastructurally, the pigment is confined to lysosomes. The pigment seems to be either an oxidative degradation product of the drug itself, or the results of an as yet unknown alteration of tyrosine metabolism by the drug. Although minocycline is known to interfere with thyroid function in animals, no evidence has been presented for such an effect in humans. The occurrence of a black thyroid gland in humans seems to be virtually pathognomonic for long-term minocycline therapy.- - - - - - - - - - ranking = 1.2keywords = black (Clic here for more details about this article) |
8/10. minocycline hydrochloride and thyroid pigmentation. A case report with histological and ultrastructural study.A 20 yr-old male, with a long history of severe acne vulgaris treated with minocycline hydrochloride, died as a result of a motor bike accident. An incidental finding at postmortem was black pigmentation of the thyroid, which was evident histologically as brown-black granules within the cytoplasm of thyroid follicular cells. Ultrastructural examination showed cytoplasmic bodies, of the same type as seen in normal thyroids. Previous cases were reviewed, and the possibility that the pigment is related to lipofuscin discussed.- - - - - - - - - - ranking = 0.4keywords = black (Clic here for more details about this article) |
9/10. Mucocutaneous lentigines, cardiomucocutaneous myxomas, and multiple blue nevi: the "LAMB" syndrome.We describe a 13-year-old girl with a cardiocutaneous syndrome characterized by an atrial myxoma, pigmented lesions of the skin and genital mucosa, and opalescent papules and dermal nodules of the skin and tongue. Her pigmented lesions included black macules of the face and vulva, brown macules of the lips and perioral skin, multiple blue nevi, and a congenital nevomelanocytic nevus. The black and brown macules of the face and vulva consisted of lentiginous proliferations of large, intensely dopa-reactive melanocytes. The opalescent papules and dermal nodules had histologic, ultrastructural, and histochemical characteristics of myxomas. During follow-up, the patient developed thyroid nodules, which were composed of mixed papillary and follicular hyperplasia. This case emphasizes the necessity of a cardiac evaluation for a potentially fatal (and surgically treatable) atrial myxoma in individuals with multiple melanocytic and myxomatous tumors of the skin and mucosa.- - - - - - - - - - ranking = 0.4keywords = black (Clic here for more details about this article) |
10/10. Drug-related pigmentation of the thyroid associated with papillary carcinoma.Black pigmentation of the thyroid attributed to minocycline hydrochloride is known, but to our knowledge, pigmentation associated with antidepressants has not been reported. We studied four patients with papillary carcinoma associated with thyroid pigmentation; two had received minocycline therapy, and two had received long-term treatment with antidepressants. The thyroids of patients who had been treated with minocycline were black, with pigment primarily in nontumorous tissue. The thyroids associated with antidepressant therapy were dark red, with pigment in both tumorous and nontumorous tissue. All four cases were positive for periodic acid-Schiff, periodic acid-Schiff with diastase predigestion, and Schmorl's stains and negative for Prussian blue; the results differed from those found with Fontana's technique. minocycline-related pigmentation appears to imply a role for the iodide peroxidase system in the accumulation of pigment, whereas pigmentation attributed to intake of antidepressants appears to result from lysosomal accumulation of the drug itself.- - - - - - - - - - ranking = 0.2keywords = black (Clic here for more details about this article) |
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