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Simple Colloid Goitre

• Goitre is defined as thyroid enlargement caused by compensatory hyperplasia and hypertrophy of follicular epithelial response to Thyroid hormone deficiency.

Etiopathogenesis

• Two morphological forms of goitre are distinguished,
–Simple or colloid goitre. –Nodular goitre.

• The presence of goitre reflects impaired synthesis of thyroid hormone, most often due to dietary deficiency of iodine. Impairment of thyroid hormone synthesis leads to a compensatory rise in serum TSH level which in turn causes hypertrophy and hyperplasia of thyroid follicular cells, which ultimately causes gross enlargement of thyroid.

Gross Appearance
• In colloid goitre the enlargement of thyroid gland is moderate, symmetric and diffuse. • Cut surface is gelatinous and translucent brown. Secondary changes such as fibrosis, haemorrhage, cystic degeneration and calcification are common in late presentations

Microscopic appearance
• The follicular epithelium shows 2 stages,Hyperplastic stage (early stage).Involution stage (late stage). • Hyperplastic stage: It is the early stage
and is characterised by tall columnar follicular epithelium showing papillary infoldings and formation of small new follicles

• Involution stage: Generally follows hyperplastic stage after variable period of time. This stage is characterised by small to large follicles distended by colloid and lined by flat follicular epithelium. Few follicles may show microscopic papillae formation. Areas of haemorhage may be seen at places. Fibrous scarring with foci of calcification may also be seen.

Flat epithelium

Colloid