Struma Lymphomatosa (Hashimoto)
1972; Elsevier BV; Linguagem: Inglês
10.1016/b978-0-08-016628-5.50010-9
AutoresPaul Neve, A.M. Ermans, P. A. Bastenie,
Tópico(s)Erythrocyte Function and Pathophysiology
ResumoSynonyms: lymphadenoid goitre, chronic lymphocytic thyroiditis, Hashimoto's disease, Hashimoto's goitre, autoimmune thyroiditis. This chapter discusses the clinical and pathological features of struma lymphomatosa or Hashimoto's thyroiditis. Hashimoto's thyroiditis probably constitutes the most frequent type of chronic goitrous thyroiditis. In general, the condition begins insidiously with a diffuse swelling of the thyroid. The swelling usually increases in a few months, or even 2 years, although it occasionally takes only a few weeks. It gives little cause for complaint beyond nervous tension and fatigue. It is rarely accompanied by pain or even discomfort. When fully developed, the goiter generally attains twice or three times the normal thyroid size. The growth is usually symmetrical, firm but not woody, and with a fine granular surface. The swollen gland is sometimes abnormally tender. The appearance of Hashimoto's goiter is striking to the naked eye; it is characterized by a diffuse swelling of the gland and a whitish, fine, granular surface of the thickened capsule; there are no adhesions or enlarged lymph nodes. The diagnosis of Hashimoto's thyroiditis should in principle be based on histological evidence. The disease may be safely diagnosed on the basis of a typical clinical picture: a firm, diffuse, and symmetrical goiter; a high sedimentation rate; a high gamma globulin level; and a high thyroid antibody titer. Surgical biopsy is only performed in the event of suspected cancer. In experienced hands, a needle biopsy is of valuable help, but it can fail to reveal a tumor. In addition to a malignant growth, the differential diagnosis must take into account nodular goiter and toxic goiter.
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