Multinodular Goiter

  Goiter means enlargement of the thyroid gland. It can be -
 1. Simple( showing uniform enlargement of the gland) OR
 2. Multinodular

 Multinodular goiter may also eventually develop in long     standing cases of simple goiter.

Patients are frequently euthyroid but may eventually  progress into hypothyroidism. They present with markedly enlarged thyroid gland.

On gross examination, the entire gland is markedly enlarged in size. Externally, it shows multiple nodules of variable sizes, some of the nodules may show necrosis and hemorrhages.

On microscopy, follicles of varying sizes lined by cuboidal to flattened epithelium are seen. The colloid may show scalloping in few follicles. Besides this, there are abundant areas of haemorrhage and necrosis, as seen in the microscopic pic.

The problems associated with Multinodular Goiter are -

1. They tend to cause pressure effects by compressing the larynx and the esophagus.

2. Long standing goiters carry a definite risk of transformation into follicular carcinoma.