CONTRIBUTION TO PATHOLOGY OF EXOPHTHALMIC GOITRE 1 5 



of the thyroid was greatly decreased. When last seen in April, 1904, 

 this improvement continued to be maintained. 



Examination of the Specimen. 



The portion removed consisted of the right lobe of the thyroid, with 

 the exception of a thin strip along its posterior border. The lobe was 

 enlarged symmetrically, and weighed 35 grammes, and measured 2 J 

 inches by i J. At its thickest portion it measured i inch. Its cut surface 

 had the same pink fleshy appearance seen in the previous cases. 

 Parathyroids could not be found. 



Microscopic Examination. — The size of the alveoli varied greatly, 

 and the large vesicles were, in shape, extremely irregular and branching, 

 while papillary projections from their walls were of frequent occurrence. 

 Colloid was more plentiful than in the former cases, but it presented the 

 same vacuolated characters, and in many instances was granular. In 

 every section there were a few scattered lymphoid deposits. These 

 generally contained a small number of plasma-cells, but there were no 

 plasma-cell-collections in the connective tissue or round the blood vessels. 

 The connective tissue between the alveoli was more abundant than in the 

 other cases. Blood vessels were fairly numerous, although the tissue 

 could not be said to be highly vascular. 



General Summary. 



The microscopic appearance of the thyroid was essentially the same 

 in all three cases, although it differed slightly in certain minor details. 

 There was in each case the same glandular hyperplasia, and the same 

 tendency to irregularity in the shape of the glandular alveoli, many of 

 which shewed papillary projections from their walls. The columnar 

 shape of the lining epithelium was always very marked, and the 

 tendency towards the columnar form could be distinctly traced even in 

 those alveoli which approximated very closely to the normal type in size, 

 shape, and in the character of their colloid contents. The amount of 

 colloid present, as compared with the normal, was in all cases diminished ; 

 in the smallest alveoli, in fact, colloid was usually absent. The characters 

 of the colloid, as seen microscopically, were altered in all cases. The 



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