Thyroid Simple Goitre 1

9. SIMPLE GOITRE

Fig 31.5 a, b, c & d

9.1 Goitrogens

      Goitrogens are substances that have the ability to inhibit hormonegenesis, they can occur in foods or may be drugs. The two groups of goitrogens are cyanogenic glucosides (cassava, sorghum, maize and millet) and thioglucoside containing substances (cabbage, kale, brussel sprouts, cauliflower, turnips and horse raddish)

A list of chemicals with hormone blocking action include

*     Phenylbutazone

*     Sulfonylureas

*     Salicytates

*     Phenytion

*     Furosemide

*     Iodides

*     Lithium

*     Proplythiouroal and

*     Carbiomizole

      The last four are usd for treatment of hyperthyroidism

9.1.1 Pathology

      Simple goitre (non-toxic, Endemic or Sporadic) when examined under the microscope may show a variable picture depending upon the stage at which it is examined.

      In the early stage there is uniform hyperplasia and hypertrophy. Repeated hyperplasia and involution cycles with the passage of time introduce alteration of thyroidal architecture with adjoining areas of hyperinvolution and hyperplasia. Fibrosis produces further demarcration of the adjoining area with at first microscopic nodularity and later followed by palpable nodularity with the growth of these nodules. Later there may be haemorrhage and calcification in any one of these areas.

      Functional autonomy in a hyperplastic nodule may result in hyperthyroidism (Toxic Multinodular Goitre)

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