GOITRE

• Diffuse enlargement of thyroid gland is called as goitre.

  

CLASSIFICATION-

I) According to WHO grading system-

a) Grade 0 – no palpable/ visible goitre

b) Grade 1 – Palpable goitre/ visible on neck extension

c) Grade 2 – Goitre visible in normal neck position

d) Grade 3 – Very large goitre

 

II) According to epidemiology-

a) Familial goitre

b) Endemic goitre

c) Sporadic goitre

 

III) According to anatomy-

a) Cervical

b) Retrosternal

c) Intrathoracic

 

IV) According to pathology-

1. Simple (diffuse) goitre-

a) Diffuse hyperplastic goitre

i) Physiological

ii) Pubertal

iii) Pregnancy

b) Multinodular goitre

 

     2. Toxic goitre-

a) Diffuse (Grave’s disease)

b) Multinodular (Plummer’s disease)

c) Toxic adenoma

 

    3. Neoplastic goitre

a) Benign

b) Malignant

 

    4. Inflammatory

a) Autoimmune (Hashimoto’s thyroiditis)

b) Granulomatous (de Quervain’s thyroiditis)

c) Fibrosing (Riedel’s thyroiditis)

d) Infective-

i) Acute- bacterial, viral

ii) Chronic- TB

 

V) According to function-

a) Toxic goitre- hyperthyroidism

b) Non- toxic goitre- hypothyroidism and euthyroid

 

VI) According to morphology

a) Diffuse enlargement

b) Multinodular goitre

c) Solitary nodule

 

ETIOLOGY-

• Physiological factor- pubery, pregnancy
• Dietary factor- iodine deficiency goitre (endemic), Goitrogens
• Hereditary factor- Dyshormonogenesis
• Autoimmune disease
• Hormonal factors
• Environmental factors- hypothyroidism

 

PATHOLOGY

 

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