Effects of Removal or Atrophy of Thyroid 



33 



Enlargement of the thyroid such as occurs in endemic goitre (fig. 22), 

 in spite of a great increase in volume of the gland, is commonly attended 



A 



B 





FIG. 22. A case of endemic goitre (A) before and (B) after treatment 

 with thyroid, (v. Brun. ) 



by symptoms of hypothyroidism ; not, as might have been expected, by 

 those of hyperthyroidism. 

 But when the enlargement 

 is the result of malignant 

 cell-proliferation (carci- 

 noma or sarcoma), the func- 

 tions of the organ may still 

 be carried on. It is indeed 

 a significant fact in con- 

 nexion with the genesis of 

 malignant tumours, that 

 when in such cases the 

 whole of the thyroid is 

 removed by the surgeon, 

 should there be any meta- 

 static growths elsewhere, 

 e.g. in the liver, the usual 

 symptoms of cachexia 

 strumipriva do not show 

 themselves. 



The enlargement of the 

 gland in endemic goitre 

 generally takes the form 

 of a diffuse hypertrophy : the follicles enlarge and their epithelium pro- 

 liferates : new follicles may also become formed. There is nearly always a 



3 



FIG. 23. Section of thyroid from a case of endemic goitre. 

 Magnified 50 diameters. Notice the enormous size of 

 some of the colloid-filled vesicles. 



