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natural history of simple diffuse goitre formation
#Endocrinology #Surgery #thyroid

Stages in goitre formation are:

● Persistent growth stimulation causes diffuse hyperplasia; all lobules are composed of active follicles and iodine uptake is uniform. This is a diffuse hyperplastic goitre, which may persist for a long time but is reversible if stim- ulation ceases.

● Later, as a result of fluctuating stimulation, a mixed pat- tern develops with areas of active lobules and areas of inactive lobules.

● Active lobules become more vascular and hyperplastic until haemorrhage occurs, causing central necrosis and leaving only a surrounding rind of active follicles.

● Necrotic lobules coalesce to form nodules filled either with iodine-free colloid or a mass of new but inactive follicles.

● Continual repetition of this process results in a nodular goitre. Most nodules are inactive, and active follicles are present only in the internodular tissue.

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owner: nerdparty67 - (no access) - McCaskie, A. W._ O'Connell, P. Ronan_ Williams, Norman S - Bailey & Love's Short practice of surgery (2018, CRC Press) -, p827


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