Pathogenesis of nodular goiter and its implications for surgical management

摘要: Despite sufficient iodine supply, goiter continues to be of considerable surgical significance in formerly endemic countries. It now appears that deficiency and increased thyrotropin stimulation are not the only causes goiter. Xenotransplantation human thyroid tissue onto nude mice allowed study regulation growth function tissue. Grafts growing could shown react endogenous mouse thyrotropic suppression. /sup 131/I autoradiographs xenotransplanted showed as marked a heterogeneity did original goitrous prior transplantation. There was no firm correlation between morphologic appearance follicle its metabolism. Scintigraphically cold hot differed from each other quantitatively but qualitatively; i.e., both were composed metabolically active nonactive follicles. Iodine organification completely suppressible by thyroxine treatment; this indicates autonomous functional activity. The distribution proliferating labeled 3/H-thymidine parallel functionally labelled 131/I. Thyroxine treatment inhibit incorporation, indicating growth. Thus, our pathogenetic concept formation is based on three mainstays: more » (1) heterogeneity, (2) autonomy function, (3) dissociation surgeon dealing with ought remove all pathologically altered tissue, nodular irrespective scintiscans. « less