Abstract

The diagnosis of thyroiditis is frequently overlooked. A review of some of the diagnostic and therapeutic problems together with a presentation of several illustrative cases has been presented. The discussion was divided into the three clinical groups (1) struma lymphomatosa of Hashimoto, (2) subacute thyroiditis and (3) struma fibrosa of Riedel. Certain difficulties of classification pathologically, especially of subacute thyroiditis, were recognized, but no support was given to the idea that these three groups represent different phases of the same process. It was considered that the diagnosis of struma lymphomatosa should rest upon the epithelial cell changes rather than on the amount of lymphoid infiltration present. The treatment of struma lymphomatosa and struma fibrosa is largely surgical, but x-ray therapy can be considered in the former. No single satisfactory form of therapy for subacute thyroiditis exists, but the results of surgery warrant its consideration in some cases. An unusual case (Case III) of struma lymphomatosa showing marked febrile and toxic reactions has been presented.

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