So many and such varied anatomic conditions have been found in connection with exophthalmic goiter that it is not easy to decide which are essential and distinctive and which non-essential and accidental. The most common of these consists in certain histologic alterations in the enlarged thyroid gland, to whose overaction the principal symptoms of the disorder appear to be due. Such alterations were found with great frequency by Dr. W. C. Mac Callum1 in a series of 28 cases studied histologically. They involved the form and size of the alveoli, the character of the epithelial cells, and of the colloid, the vascular supply, the connective-tissue framework and the lymphoid structures of the thyroid gland. The alveoli vary greatly in size and form, the epithelium of many being folded in such a manner as to yield an appearance of sending off long diverticula, which frequently become constricted off and form
THE PATHOLOGIC ANATOMY OF EXOPHTHALMIC GOITER. JAMA. 1905;XLV(26):1960. doi:10.1001/jama.1905.02510260046012
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