Comparing thyroid ultrasonography to thyroid function in long-term survivors of childhood lymphoma

Background. We studied the value of thyroid ultrasonography as a follow-up tool in survivors of childhood lymphomas and correlated morphologic abnorma lities with thyroid function tests. Procedure. A prospective follow-up stud y of 45 long-term survivors of histology-proved childhood lymphomas was per formed. Mean age at diagnosis was 9.1 years (range 2.1-16.4 years) and mean follow-up duration 10.9 years (range 3.9-22.2 years). Results. Among the 2 6, survivors of Hodgkin disease (HD) who received mantle field irradiation, 14 (54%) had abnormal ultrasonograms. Elevated thyroid-stimulating hormone (TSH) concentrations were found in 14 (54%), and 6 of them (42%) had norma l thyroid functions, Six of twelve patients with normal ultrasonograms had abnormal thyroid function, and 5 of 11 patients with normal function had ab normal sonograms. Among the 19 non-HD survivors who did not receive radioth erapy, 18 1(95%) had both normal sonograms and normal function. Thus thyroi d gland abnormalities were detected in 54% of HD survivors after mantle fie ld irradiation. No correlation between the abnormalities detected on ultras onography and serum levels of TSH and thyroid hormones were found. Conclusi ons. Both ultrasound and thyroid function tests independently provide clini cally useful information; the former examines gland morphologogy and the la tter evaluates hormonal changes associated with thyroid disease. The high f requency of thyroid abnormalities detected by ultrasonography suggests that periodic thyroid ultrasonography is advisable in the follow-up of patients treated with mantle irradiation to screen for morphologic changes that may presage malignant transformation. (C) 2000 Wiley-Liss, Inc.