[Pathogenetic problems of goiter].

The extrafollicular growth (hyperplasia) of the thyroid parenchyma resulting in the development of epithelial goiter begins with proliferation of thyrocytes of the follicular wall (sometimes called "clear cells" and erroneously identified with the parafollicular cells or C-cells). An important role in the pathogenesis of goiter disease belongs to the transition of the thyroid parenchyma hyperplasia from the initial adaptative (compensatory) reaction which arises under conditions of thyroid hormone production deficiency into the irreversible pathological process of indefinite duration after restoration of the euthyroid state of the patient. It may be assumed that this transition results from stabilization of gradually increasing shift of protein biosynthesis in the thyrocytes towards preferential thyroalbumin formation at the expense of thyroglobulin.