DAVID MARINE 



in the intermediate and fetal adenomas. The epithelium in the growing 

 phase of simple adenomas is distinctly columnar and becomes more cu- 

 boidal in the intermediate and fetal groups. In the colloid phase all 

 groups have cuhoidal epithelium as the ruling type. Infoldings and plica- 

 tions are usually present in simple adenomas while they are rarely 

 present or only rudimentary in the intermediate, and are absent from 

 the fetal adenomas. The colloid content of all groups is much reduced 

 during the growing phases. (The secondary and terminal metamorphoses 

 of adenomas will be discussed under "Complications".) 



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Fig. 28. Fetal adenoma, illustrating Fig. 29. Interior of fetal adenoma in 

 tile tubular ell'ect. Section taken from the colloid phase illustrating more marked 

 center of an adenoma whose nutrition is degree of failing nutrition, hyalinized 



impaired and illustrates the early re- 

 gressive change leading to cyst formation. 

 (J. Med. Research, 1913: 27.) 



stroma. (After Marine, J. Med. Research, 

 1913: 27.) 



Carcinoma. The diagnosis of thyroid carcinoma is difficult because of 

 the wide range of typical and atypical cell proliferation which may take 

 place within physiological limits. The cell picture is often of little aid, 

 and in the absence of metastases, other features such as the gross appear- 

 ance, the history, and the effect of the administration of iodin should be 

 sidered. Goiter, and particularly adenomas, are the most important pre- 

 cursors of human thyroid cancer. Carcinoma developing from the nor- 

 mal thyroid must be rare. There are reports of such cases, but all of 

 these are susceptible of other interpretations. No satisfactory morpho- 

 logical grouping of thyroid cancers is possible. The more commonly ob- 

 served types are: 



Carcinoma simplex. 

 Adeno-carcinonia. 

 Scirrhus carcinoma. 



Papillary cystic carcinoma. 

 Squamous cell carcinoma. 



