. General surgical pathology and therapeutics, in fifty-one lectures .. . s of the thyroid gland have long beencalled goitre, struma (in the middle ages strumous indicated whatwe at present call scrofulous ). Considering the anatomical rela- 672 TUMORS. tion of these tumors to the gland, we find that there are diffuse swellings of the gland, affecting one or both lobes, and others that are dis-tinctly bounded in the gland, the latter remaining normal or butslightly hypertrophic. If we exclude simple cysts of the thyroid, so-called struma cystica, most other forms of goitre are pure adenoma orc
. General surgical pathology and therapeutics, in fifty-one lectures .. . s of the thyroid gland have long beencalled goitre, struma (in the middle ages strumous indicated whatwe at present call scrofulous ). Considering the anatomical rela- 672 TUMORS. tion of these tumors to the gland, we find that there are diffuse swellings of the gland, affecting one or both lobes, and others that are dis-tinctly bounded in the gland, the latter remaining normal or butslightly hypertrophic. If we exclude simple cysts of the thyroid, so-called struma cystica, most other forms of goitre are pure adenoma orcysto-adenoma. If the tissue of these tumors, which may vary greatlyin consistence, be not metamorphosed by secondary changes, on sectionit appears to the naked eye almost the same as the cut surface of anormal thyroid gland. Microscopically also it is very much the same;almost all thyroid tumors on microscopic examination show a largeamount of connective-tissue capsules, which contain a clear gelatinoussubstance filled with more or less round pale cells (Fig. 151). The. From an ordinary firm tumor of the thyroid—adenoma of the thyroid; partial 100 diameters. size of these varies greatly, the youngest, which as yet contain nogelatinous substance, but only cells, being analogous to the foetalthyroid vesicles, while the larger are six or ten times this size. Oneof the most frequent changes in goitre-tumors is the formation ofcysts, which come from a number of the dilating gland-vesicles uniting,and their thick gelatinous contents becoming fluid. But, besides thisformation of cysts in goitres, there are other just as frequent changesthat occur almost regularly if the goitre exists a long time: these areextravasations of blood, which are mostly reabsorbed, but leave moreor less pigmentation. Caseous and fatty degeneration is also frequentin old goitres; lastly, calcareous degeneration often occurs, so that bythese secondary changes the original picture of the t
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