Thyroid gland shows nodular adenomatous hyperplasia. Nodules are variable in size and composed of small and large crowded follicles full of thick colloid and lined by mature epithelium. Sections from some of the nodules show compact microfollicles devoid of colloid and lined by cuboidal cells separated by delicate vascular stroma. In these follicles nuclei are vesicular and look active but no appreciable mitosis. Stroma shows mild fibrosis and show focal dense infiltration by lymphocytes amounting at the formation of lymphoid follicles with intact active germinal centers. Related follicles show degeneration but no evidence of oxyphil change of the follicular epithelium. No evidence of hyperfunction or malignancy.
Three lymph nodes were identified showing reactive follicular hyperplasia.
Multinodular Goiter with retrosternal and retrovascular extension in the anterior neck region.
Total thyroidectomy specimen composed of two thyroid lobes and an isthmus with intact capsule. The first lobe measured 6.5 x 3 x 2.5 cm and showed four greyish nodules, the largest of which measured 2.5 x 2.3 cm. A small cystic area measuring 0.4 cm was also identified. The second lobe measured 7.5 x 5 x 4 cm and showed three greyish nodules. The largest nodule measured 4.8 x 3.8 x 3.5 cm. The isthmus measured 1.5 x 1.2 cm.
Thyroid gland, total thyroidectomy: