SONOGRAPHIC ABNORMALITIES OF THE THYROID-GLAND FOLLOWING RADIOTHERAPYIN SURVIVORS OF CHILDHOOD HODGKINS-DISEASE

The aims of this study were as follows. (1) To demonstrate the spectru m, frequency and changes on followup of sonographic abnormalities in t he thyroid gland of survivors of Hodgkin's disease who had received ra diotherapy to the neck in childhood. (2) To compare the sonographic fi ndings with clinical examination and radionuclide imaging. (3) To inve stigate the association between the presence or absence of focal sonog raphic abnormalities with age at radiotherapy: the interval from radio therapy, the presence of a raised thyroid stimulating hormone (TSH) an d the length of time the TSH had been raised. 46 patients were scanned prospectively and rescanned at 6-18 months. The mean age at first son ography was 22.7 years, the median age at radiotherapy was 12.5 years, and the median interval post-radiation was 10.3 years. Sonographic ab normalities were seen in all 46 patients. 45 had diffuse atrophy and 3 0 had focal sonographic abnormalities. 18 patients developed new focal sonographic abnormalities on follow-up. Focal sonographic abnormaliti es were more commonly associated with longer duration of a raised TSH. Two patients had thyroid carcinoma. Sonographic abnormalities of the thyroid are common in patients following neck radiotherapy in childhoo d. Focal abnormalities are usually associated with a longer duration o f raised TSH.