Archives of internal medicine . thelining epithelium and the absence of colloid. DAVID MAIUXE—C. //. LEX RANT 517 a general increase in its blood-supply, a general decrease in the stainablecolloid and a general change from cuboidal to columnar epithelium. Ifthese changes continue to the stage of cell proliferation, the conditionis properly designated as hyperplasia. There are all degrees of the abnor-mal cell growth from the slightest departure from normal (hypertrophy)to the marked proliferation (hyperplasia). Hyperplasia is the anatomical evidence of increased physiologicalactivity of the gl
Archives of internal medicine . thelining epithelium and the absence of colloid. DAVID MAIUXE—C. //. LEX RANT 517 a general increase in its blood-supply, a general decrease in the stainablecolloid and a general change from cuboidal to columnar epithelium. Ifthese changes continue to the stage of cell proliferation, the conditionis properly designated as hyperplasia. There are all degrees of the abnor-mal cell growth from the slightest departure from normal (hypertrophy)to the marked proliferation (hyperplasia). Hyperplasia is the anatomical evidence of increased physiologicalactivity of the gland, and the instances in which visible goiters appear areonly accidents, so to speak, since the great majority of all hyperplasias inall animals never reach that degree of proliferation which could be clin-ically diagnosed as goiter. Clinically, therefore, goiter is relatively rare,while anatomically it is extremely common if one uses the term goiter,as we believe it should be used, in its anatomical-patliological sense. All. Fig. 16.—True fetal adenoma showing relation to capsule. these degrees of hyperplasia are to be considered as stages in the commonprocess of goiter development. In pre\ious publications we have empha-sized the great frequency of active hyperplasia in dogs, sheep, cattle, hoo-s,fish and man. Tracing tlie development of hypertrophy and hyperplasia from thenormal gland, the first change noticed in the thyroid is its increasedblood-supply. The capsular vessels dilate and hypertrophy and becometortuous. capillaries surrounding the follicles are dilated. Thegland becomes larger, softer and takes on a brighter red color. Micro- 6. Marine and Williams: The Archives Int. IflOS. i. 349. :^Iarine andLenhart, ibid., 1900. iii, 66: 1900. iv. 440: Jour. Exper. 1010. xii. 311. 518 THE ARCHIVES OF IXTERXAL MEDICINE
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