. The thyroid gland in health and disease. FiG. 14.— Section of goitrous thyroid of rat which suffered from symptomsresembling tetany. Note high columnar epithelium, disappearing colloid, irregularshaped vesicles, the piling up of the epithelium forming buds. There is alsomarked capillary congestion which is not well shown in figure. X 166. 66 PATHOLOGY of the individual, and the glands powers of response to toxic orother stimuli. Depending also on these factors it progresses toa definite end. Thus, under certain conditions of malnutrition,such as may occur in severe toxaemias of intestinal or
. The thyroid gland in health and disease. FiG. 14.— Section of goitrous thyroid of rat which suffered from symptomsresembling tetany. Note high columnar epithelium, disappearing colloid, irregularshaped vesicles, the piling up of the epithelium forming buds. There is alsomarked capillary congestion which is not well shown in figure. X 166. 66 PATHOLOGY of the individual, and the glands powers of response to toxic orother stimuli. Depending also on these factors it progresses toa definite end. Thus, under certain conditions of malnutrition,such as may occur in severe toxaemias of intestinal origin, or, asa result of infectious diseases, the glands powers of response arelimited in greater or lesser degree, so that after a more or lessabortive attempt at the process of hyperplasia, atrophy of thesecreting cells occurs and they are replaced by fibroblasts (, 51). This result is especially liable to occur in persons. Fig. 15.—Active thyroid hyperplasia of marked degree. Note the irregularsize and distortion of follicles, infoldings and plications of the lining epithelium ;the regular and uniform, high columnar epithelium ; the absence of true colloidand the generalized increase of stroma. (Reproduced by courtesy of Dr. DavidMarine, Cleveland.) over the age of forty years, in whom senile atrophy mayalready have begun. Under these circumstances no swellingof the gland will occur at any stage of the process. In thisway cases of myxcedema or hypothyroidism may arise in yoiuigpeople as well as in adults, the severity of the resultantsymptoms depending on the extent of the cell-death and fibrosis(figs. 23, 24). In other cases where conditions of malnutrition and thvroid COLLOID GOITRE 67 impoverishment are not paramount, the hyperplastic processtakes one of two courses ; 1. It reverts to the colloid state, forming the so-called colloid goitre, or 2. It continues without any period of rest, ultimately
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