Lundström B, Norrby K
Br J Surg. 1980 May;67(5):357-9. doi: 10.1002/bjs.1800670520.
Two main patterns of hyperplasia of the thyroid epithelium are seen in hyperthyroidism--toxic diffuse hyperplasia and toxic nodular hyperplasia. Toxic diffuse hyperplasia may affect the entire gland or it may arise in the extranodular tissue in a gland with nodular lesions. A series of patients treated by subtotal thyroidectomy for hyperthyroidism were classified into three morphological groups of goitre: 98 had a toxic diffuse goitre (TDG), 58 toxic nodular goiter with diffuse hyperplasia (TNGDH), and 105 toxic nodular goitre with nodular hyperplasia (TNGNH). The type of goitre was correlated to the development of disturbed thyroid function 1-6 years after surgery. Twenty-two patients with TDG and 18 (31 per cent) with TNGDH developed hypothyroidism; only 3 (3 per cent) with TNGNH showed hypofunction. Six patients with recurrent hyperthyroidism were found; all showed diffuse hyperplasia of the gland. It is concluded that the development of disturbed thyroid function after surgery is closely related to the histopathological type of goitre.
甲状腺功能亢进症可见两种主要的甲状腺上皮增生模式——毒性弥漫性增生和毒性结节性增生。毒性弥漫性增生可累及整个腺体，也可出现在有结节性病变腺体的结节外组织中。一组因甲状腺功能亢进症接受甲状腺次全切除术治疗的患者被分为三种形态学类型的甲状腺肿：98例为毒性弥漫性甲状腺肿（TDG），58例为伴有弥漫性增生的毒性结节性甲状腺肿（TNGDH），105例为伴有结节性增生的毒性结节性甲状腺肿（TNGNH）。甲状腺肿的类型与术后1 - 6年甲状腺功能紊乱的发生相关。22例TDG患者和18例（31%）TNGDH患者出现甲状腺功能减退；只有3例（3%）TNGNH患者出现甲状腺功能减退。发现6例复发性甲状腺功能亢进症患者；所有患者均表现为腺体弥漫性增生。结论是，术后甲状腺功能紊乱的发生与甲状腺肿的组织病理学类型密切相关。
