A Characterization of Focal Lymphocytic Thyroiditis

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OF the various benign, inflammatory lesions affecting the thyroid gland, focal lymphocytic thyroiditis has been one of those most neglected in the past. Recently, interest in this lesion has grown, primarily to determine its true significance and, more specifically, its relationship to the diffuse form of lymphocytic thyroiditis (struma lymphomatosa) described by Hashimoto1 in 1912. The diffuse form is a recognized clinicopathologic entity, and in accord with recent studies on the association of circulating, thyroid autoantibodies with human and experimental thyroiditis,2 struma lymphomatosa is now widely regarded as the prototype of autoimmune disease. Morphologically, the focal type of lymphocytic thyroiditis appears to be a patchy variety of the diffuse type. It has been suggested3, 4 that the focal lesion represents the earliest morphologic evidence of immunologic damage to the thyroid gland. If the concept is correct, then one would expect to find a significant frequency of association of this focal lesion with many of the possibly autoimmune diseases. Indeed, such association has been reported between focal lymphocytic thyroiditis and collagen diseases,5 diabetes mellitus,6 and pernicious anemia.7, 8

In view of the great interest, at this institution, in thyroid pathology, and the availability of a large volume of appropriate surgical and autopsy material, a study was undertaken to explore further the nature and the significance of focal lymphocytic thyroiditis and its relationship to other thyroid and systemic diseases.

Materials and Methods

Plan of study. In this study, 797 thyroid glands, 397 removed at operations and 400 at autopsies, were examined. It. . .



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