25320              LARGE THYROID ADENOMA

The patient was a woman aged 75 who was admitted to hospital with a left hemiplegia and collapse. A swelling was palpable on the left side of the neck. She died after 5 days, and at postmortem recent softenings in the right parietal lobule and cerebellum were found, together with old sunken cortical softenings of the right hippocampus and right occipital cortex.

The specimen consists of the larynx, thyroid and upper trachea. The left lobe of the thyroid is largely replaced by a spheroidal adenomatous mass measuring 9 x 6 x 6 cms. Its cut surface is lobulated and shows many areas of interstitial haemorrhage and some cellular necrosis. A compressed strip of relatively normal thyroid tissue is visible to the left of the adenoma. The trachea is displaced markedly to the right. The right lobe of the thyroid is small, but also shows nodular hyperplasia. Histology shows an inactive adenoma composed mostly of small alveoli with low epithelium and much colloid. There are many areas of haemorrhage and necrosis. The right lobe appears similar but the acini are larger.