9. =Thyroid.= _Weight_ is 30-60 grms. The _dimensions_ of the lateral
lobes are: Length 5-7 cm., breadth 3-4 cm., thickness 1.5-2.5 cm.
They should be symmetrical. Note variation in _form_, character of
_cut-surface_ (normally glassy, granular and yellowish-pink). The
colloid is transparent, yellow or brown in color, and rises above
the cut-surface. Cysts of varying size are very common, likewise
encapsulated adenomata. A firm, yellowish, moderately enlarged
thyroid is often seen in cases of pulmonary tuberculosis. Increase
of the stroma with hyaline change and calcification is common.
The most important pathologic conditions of the thyroid are:
_goitre_ (struma diffusa, nodosa, maligna, benigna, parenchymatosa,
hyperplastica, adenomatosa, colloides, gelatinosa, cystica,
vasculosa, fibrosa, hæmorrhagica, calculosa, ossea, amyloides,
inflammatoria, etc.), _inflammation_ (thyreoditis simplex, purulenta,
abscess), _neoplasms_ (carcinoma the most common form of malignant
tumor, sarcoma not rare, adenoma and cystadenoma very common,
combinations of sarcoma and carcinoma have been observed; other forms
rare), _granulomata_ (tubercles and gummata are rare), _parasites_
(echinococcus). Especial examination should be made of the thyroid
in cretinism, myxœdema, all forms of cachexia of unknown etiology,
infantilism, lymphatic constitution, unexplained death, rachitis,
chondrodystrophia, acromegaly, giantism, idiocy, etc. In marked
constitutional disturbances conditions of athyreosis, thyreoplasia
and hyperplasia of the thyroid may play an etiologic rôle. Accessory
thyroids are not uncommon in the neck, in the supraclavicular fossæ
and behind the sternum. They usually show the structure of fœtal
adenomata, but may become cystic or undergo carcinomatous change.
10. =Parathyroids.= These organs are usually four in number,
sometimes more, sometimes only one or two. They are usually paired,
and are found near the inner posterior borders of the lobes of the
thyroid, near the two terminal branches of the inferior thyroid
artery. They vary in size from 3-15 mm. in length, 3-4 mm. broad,
by 1-2 mm. in thickness. They are normally brown in color, and
soft in consistence. It is often difficult to distinguish them
from the hæmolymph nodes that are common in this region. The
parathyroids should be examined in all cases of tetany, paralysis
agitans, acromegaly, epilepsy, infantile atrophy, myotonia and
obscure cachexias. Conditions of supposed hypoparathyreosis have
been reported. Hypertrophy of the parathyroids has been observed in
acromegaly. Adenoma has been described by several writers. Cysts,
fatty degeneration, fatty infiltration, colloid degeneration, cloudy
swelling and tuberculosis have been reported as occurring.
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