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Surgical Aspects of Thyroiditis

Surgical Aspects of Thyroiditis Abstract Reports from various centers indicate that Hashimoto thyroiditis is increasing in frequency.9,15,17 There are two schools of thought regarding its treatment, and willingness to use medical treatment depends on confidence in the accuracy of the diagnosis. We have undertaken a study of 1,000 consecutive operations done for nontoxic goiter in an attempt to determine (1) the degree of diagnostic accuracy in current surgical practice; (2) the indications or contraindications for surgical treatment of thyroiditis, and (3) how increasing knowledge of the natural history of Hashimoto thyroiditis may alter some current methods of management. The series of operations was obtained from the files of the U.C.L.A. Medical Center and from two accredited private hospitals near the Medical Center, St. John's and Santa Monica hospitals. All cases of toxic diffuse goiter have been excluded from this study because the ubiquitous lymphoid accumulations accompanying Graves' disease are interpreted by some pathologists as References 1. Beare, R. L. B.: Lymphadenoid Goitre (Hashimoto's Disease) , Brit. M.J. 1:480-486 ( (March) ) 1958.Crossref 2. Dailey, M. E.; Lindsay, S., and Skahen, R.: Relation of Thyroid Neoplasms to Hashimoto's Disease of the Thyroid Gland , A.M.A. Arch. Surg. 70:291-297 ( (Feb.) ) 1955.Crossref 3. Doniach, D.; Roitt, I. M., and Hudson, R. V.: Auto-Immunity and Thyroid Disorders , Postgrad. M.J. 35:324-329 ( (June) ) 1959Crossref 4. Dunning, E. J.: Struma Lymphomatosa: A Report of Three Cases in One Family , J. Clin. Endocrinol. 19:1121-1125 ( (Sept.) ) 1959.Crossref 5. Farber, S., and Craig, J. M.: Clinical Pathological Conference: Children's Medical Center, Boston , J. Pediat. 53:494-502 ( (Oct.) ) 1958.Crossref 6. Freeman, G. C.: The Thyroid Nodule , A.M.A. Arch. Surg. 79:129-134 ( (July) ) 1959.Crossref 7. Gribetz, D.; Talbot, N. B., and Crawford, J. D.: Goiter Due to Lymphocytic Thyroiditis (Hashimoto's Struma): Its Occurrence in Preadolescent and Adolescent Girls , New England J. Med. 250:555-557 ( (April 1) ) 1954.Crossref 8. Hellwig, C. A.: Lymphadenoid Goiter , Arch. Path. 25:838-849 ( (June) ) 1938. 9. Hendrick, J. W.: Diagnosis and Treatment of Thyroiditis , Ann. Surg. 144:176-178 ( (Aug.) ) 1956.Crossref 10. Hubble, D.: The Diagnosis and Treatment of Auto-Immunising Thyroiditis , Scottish M.J. 4:55-63 ( (Feb.) ) 1959. 11. Lindsay, S.; Dailey, M. E., and Jones, M. D.: Histologic Effects of Various Types of Ionizing Radiation on Normal and Hyperplastic Human Thyroid Glands , J. Clin. Endocrinol. 14:1179-1218 ( (Oct.) ) 1954.Crossref 12. Luxton, R. W.: Discussion on Hashimoto's Disease , Proc. Roy. Soc. Med. 50:943-962 ( (Nov.) ) 1957. 13. Lyday, R. O.: Struma Lymphomatosa (Hashimoto's Disease) in Children , Am. J. Surg. 94:417-421 ( (Sept.) ) 1957.Crossref 14. Marshall, S. F., and Meissner, W. A.: Struma Lymphomatosa (Hashimoto's Disease) , Ann. Surg. 141:737 ( (May) ) 1959.Crossref 15. McConahey, W. M.; Woolner, L. B.; Black, B. M., and Keating, F. R.: Effect of Desiccated Thyroid in Lymphocytic (Hashimoto's) Thyroiditis , J. Clin. Endocrinol. 19:45-52 ( (Jan.) ) 1959.Crossref 16. Meier, D. W.; Woolner, L. B.; Beahrs, O. H., and McConahey, W. M.: Parenchymal Findings in Thyroidal Carcinoma; Pathologic Study of 256 Cases , J. Clin. Endocrinol. 19:161-171 ( (Jan.) ) 1959. 17. Mudge, T. J.; Sellett, T., and Nemecek, R. W.: The Changing Pattern of Thyroid Disease , Surgery 43:622-630 ( (April) ) 1958. 18. Owen, C. A.: A Review of "Auto-Immunization" in Hashimoto's Disease , J. Clin. Endocrinol. 18:1015-1024 ( (Sept.) ) 1958.Crossref 19. Ricca, J. J.; Morrione, T. G., and Adel, H.: Struma Lymphomatosa (Hashimoto's Disease): Report of a Case in a 13-Year-Old Boy , A.M.A. J. Dis. Child. 92:592-595 ( (Dec.) ) 1956.Crossref 20. Roitt, I. M., and Doniach, D.: Human Auto-Immune Thyroiditis; Serological Studies , Lancet 2:1027-1033 ( (Nov. 15) ) 1958.Crossref 21. Skillern, P. G.; Crile, G., Jr.; McCullagh, E. P.; Hazard, J. B.; Lewis, L. A., and Brown, H.: Struma Lymphomatosa: Primary Thyroid Failure with Compensatory Thyroid Enlargement , J. Clin. Endocrinol. 16:35-54 ( (Jan.) ) 1956.Crossref 22. Spjut, H. J.; Warren, W. D., and Ackerman, L. V.: Clinical-Pathologic Study of 76 Cases of Recurrent Graves' Disease, Toxic (Non-Exophthalmic) Goiter and Nontoxic Goiter: Does a Relation Exist Between Thyroid Hyperplasia and Struma Lymphomatosa? Am. J. Clin. Path. 27:367-392 ( (April) ) 1957. 23. Statland, H.; Wasserman, M. M., and Vickery, A. L.: Struma Lymphomatosa (Hashimoto's Struma): Review of 51 Cases with Discussion and Endocrinologic Aspects , A.M.A. Arch. Int. Med. 88:659-688 ( (Nov.) ) 1951.Crossref 24. Woolner, L. B.; McConahey, W. M., and Beahrs, O. H.: Struma Lymphomatosa (Hashimoto's Thyroiditis) and Related Thyroidal Disorders , J. Clin. Endocrinol. 19:53 ( (Jan.) ) 1959.Crossref 25. Yeager, G. H.; Workman, J. H.; Holbrook, W. A., and Patten, D. H.: Thyroiditis: A Review and Presentation of 40 Pathologically Proven Cases of Chronic Thyroiditis , South. M.J. 50:1005-1012 ( (Aug.) ) 1957.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives Surgery American Medical Association

Surgical Aspects of Thyroiditis

POLLOCK, W. F.; SPRONG, D. H.
A.M.A. Archives Surgery , Volume 80 (5) – May 1, 1960
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References (25)

Publisher
American Medical Association
Copyright
Copyright © 1960 American Medical Association. All Rights Reserved.
ISSN
0096-6908
DOI
10.1001/archsurg.1960.01290220012003
Publisher site
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Abstract

Abstract Reports from various centers indicate that Hashimoto thyroiditis is increasing in frequency.9,15,17 There are two schools of thought regarding its treatment, and willingness to use medical treatment depends on confidence in the accuracy of the diagnosis. We have undertaken a study of 1,000 consecutive operations done for nontoxic goiter in an attempt to determine (1) the degree of diagnostic accuracy in current surgical practice; (2) the indications or contraindications for surgical treatment of thyroiditis, and (3) how increasing knowledge of the natural history of Hashimoto thyroiditis may alter some current methods of management. The series of operations was obtained from the files of the U.C.L.A. Medical Center and from two accredited private hospitals near the Medical Center, St. John's and Santa Monica hospitals. All cases of toxic diffuse goiter have been excluded from this study because the ubiquitous lymphoid accumulations accompanying Graves' disease are interpreted by some pathologists as References 1. Beare, R. L. B.: Lymphadenoid Goitre (Hashimoto's Disease) , Brit. M.J. 1:480-486 ( (March) ) 1958.Crossref 2. Dailey, M. E.; Lindsay, S., and Skahen, R.: Relation of Thyroid Neoplasms to Hashimoto's Disease of the Thyroid Gland , A.M.A. Arch. Surg. 70:291-297 ( (Feb.) ) 1955.Crossref 3. Doniach, D.; Roitt, I. M., and Hudson, R. V.: Auto-Immunity and Thyroid Disorders , Postgrad. M.J. 35:324-329 ( (June) ) 1959Crossref 4. Dunning, E. J.: Struma Lymphomatosa: A Report of Three Cases in One Family , J. Clin. Endocrinol. 19:1121-1125 ( (Sept.) ) 1959.Crossref 5. Farber, S., and Craig, J. M.: Clinical Pathological Conference: Children's Medical Center, Boston , J. Pediat. 53:494-502 ( (Oct.) ) 1958.Crossref 6. Freeman, G. C.: The Thyroid Nodule , A.M.A. Arch. Surg. 79:129-134 ( (July) ) 1959.Crossref 7. Gribetz, D.; Talbot, N. B., and Crawford, J. D.: Goiter Due to Lymphocytic Thyroiditis (Hashimoto's Struma): Its Occurrence in Preadolescent and Adolescent Girls , New England J. Med. 250:555-557 ( (April 1) ) 1954.Crossref 8. Hellwig, C. A.: Lymphadenoid Goiter , Arch. Path. 25:838-849 ( (June) ) 1938. 9. Hendrick, J. W.: Diagnosis and Treatment of Thyroiditis , Ann. Surg. 144:176-178 ( (Aug.) ) 1956.Crossref 10. Hubble, D.: The Diagnosis and Treatment of Auto-Immunising Thyroiditis , Scottish M.J. 4:55-63 ( (Feb.) ) 1959. 11. Lindsay, S.; Dailey, M. E., and Jones, M. D.: Histologic Effects of Various Types of Ionizing Radiation on Normal and Hyperplastic Human Thyroid Glands , J. Clin. Endocrinol. 14:1179-1218 ( (Oct.) ) 1954.Crossref 12. Luxton, R. W.: Discussion on Hashimoto's Disease , Proc. Roy. Soc. Med. 50:943-962 ( (Nov.) ) 1957. 13. Lyday, R. O.: Struma Lymphomatosa (Hashimoto's Disease) in Children , Am. J. Surg. 94:417-421 ( (Sept.) ) 1957.Crossref 14. Marshall, S. F., and Meissner, W. A.: Struma Lymphomatosa (Hashimoto's Disease) , Ann. Surg. 141:737 ( (May) ) 1959.Crossref 15. McConahey, W. M.; Woolner, L. B.; Black, B. M., and Keating, F. R.: Effect of Desiccated Thyroid in Lymphocytic (Hashimoto's) Thyroiditis , J. Clin. Endocrinol. 19:45-52 ( (Jan.) ) 1959.Crossref 16. Meier, D. W.; Woolner, L. B.; Beahrs, O. H., and McConahey, W. M.: Parenchymal Findings in Thyroidal Carcinoma; Pathologic Study of 256 Cases , J. Clin. Endocrinol. 19:161-171 ( (Jan.) ) 1959. 17. Mudge, T. J.; Sellett, T., and Nemecek, R. W.: The Changing Pattern of Thyroid Disease , Surgery 43:622-630 ( (April) ) 1958. 18. Owen, C. A.: A Review of "Auto-Immunization" in Hashimoto's Disease , J. Clin. Endocrinol. 18:1015-1024 ( (Sept.) ) 1958.Crossref 19. Ricca, J. J.; Morrione, T. G., and Adel, H.: Struma Lymphomatosa (Hashimoto's Disease): Report of a Case in a 13-Year-Old Boy , A.M.A. J. Dis. Child. 92:592-595 ( (Dec.) ) 1956.Crossref 20. Roitt, I. M., and Doniach, D.: Human Auto-Immune Thyroiditis; Serological Studies , Lancet 2:1027-1033 ( (Nov. 15) ) 1958.Crossref 21. Skillern, P. G.; Crile, G., Jr.; McCullagh, E. P.; Hazard, J. B.; Lewis, L. A., and Brown, H.: Struma Lymphomatosa: Primary Thyroid Failure with Compensatory Thyroid Enlargement , J. Clin. Endocrinol. 16:35-54 ( (Jan.) ) 1956.Crossref 22. Spjut, H. J.; Warren, W. D., and Ackerman, L. V.: Clinical-Pathologic Study of 76 Cases of Recurrent Graves' Disease, Toxic (Non-Exophthalmic) Goiter and Nontoxic Goiter: Does a Relation Exist Between Thyroid Hyperplasia and Struma Lymphomatosa? Am. J. Clin. Path. 27:367-392 ( (April) ) 1957. 23. Statland, H.; Wasserman, M. M., and Vickery, A. L.: Struma Lymphomatosa (Hashimoto's Struma): Review of 51 Cases with Discussion and Endocrinologic Aspects , A.M.A. Arch. Int. Med. 88:659-688 ( (Nov.) ) 1951.Crossref 24. Woolner, L. B.; McConahey, W. M., and Beahrs, O. H.: Struma Lymphomatosa (Hashimoto's Thyroiditis) and Related Thyroidal Disorders , J. Clin. Endocrinol. 19:53 ( (Jan.) ) 1959.Crossref 25. Yeager, G. H.; Workman, J. H.; Holbrook, W. A., and Patten, D. H.: Thyroiditis: A Review and Presentation of 40 Pathologically Proven Cases of Chronic Thyroiditis , South. M.J. 50:1005-1012 ( (Aug.) ) 1957.Crossref

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A.M.A. Archives Surgery – American Medical Association

Published: May 1, 1960

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