44 
are hard, others fluctuate, suggesting cystic de- 
g'eneration. Below these nodules are two bodies, 
also bilateral, evidently lobes of the thyroid. 
Each measures 5 cm. long, 2.5 cm. wide, 2.5 cm. 
deep. They are firm, with some foci of cystic 
softening. From a ruptured cyst of the right lobe 
grumous, red malodorous material exudes. Per- 
ipheries of such cyst show greenish discolorations. 
Bodies as a whole are a greenish-black color. 
They are well encapsulated. They do not meet 
in the midline but are joined at lower poles by 
firm, apparently colloid, material. 
The microscopical section is round and enclosed by 
a firm, fibrous capsule. In places the surround- 
ing loose areolar tissue is adherent, appearing as 
a delicate loose fibrous tissue enclosing typical 
polynuclears, plasma cells, and fibroblasts. The 
firm old dense capsule is very irregular in thick- 
ness, seemingly on account of the penetration of 
the enclosed tumor cells. Such infiltration gives 
the inner outline of the capsule a very irregular 
bizarre appearance, and at times thins the capsule 
until it is reduced to nil. In one place the tumor 
elements appear outside the capsule at a point 
where a large vessel is apposed to outside of cap- 
sule. 
The appearances within this capsule vary. In 
places the picture is that of a carcinoma. Small 
round, interspersed with larger, irregular-shaped 
acini are seen lined by a single layer of low cu- 
boidal epithelium. Very frequently, indeed, these 
lining cells contain fine granules of golden-brown 
pigment, even where their lumina contain no 
blood. Some of the larger acini contain altered 
blood cells and a smooth pink material, knife 
streaked and vacuolated peripherally. In some 
parts of section these acini are regular and well- 
formed. In others they are very irregular and 
appear to be eroding the capsule. A second ap- 
