A STATISTICAL STUDY OF THE CLINICAL SIGNIFICANCE OF LYMPHOCYTIC AND FIBROCYTIC REPLACEMENTS IN THE HYPERPLASTIC THYROID GLAND*†

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Abstract
Lymphocytes and fibrous tissue have long been recognized as integral parts of the pathologic picture of exophthalmic goiter but the significance of such tissue has not been widely studied. Previous assumptions, based on isolated cases, have linked increased replacement of parenchyma by lymphocytes and fibrous tissue to reduction in toxicity. In 86 cases of exophthalmic goiter with associated thyroiditis, the mean grade and the standard deviation of the grade of parenchymal replacement by thyroiditic tissue were calculated after examination of multiple sections of tissue from each gland. Replacement was either by lymphocytes alone or by both fibrous tissue and lymphocytes. Patients with the mixed fibrolymphocytic type were somewhat older than patients with the lymphocytic type. Female patients showed greater replacement than male patients in each decade. With greater degrees of replacement the basal metabolic rates were lower and the incidence of auricular fibrillation was less. The incidence of exophthalmos increased progressively with increasing degrees of replacement. The incidence of postoperative myxedema rose progressively with the degree of parenchymal replacement. In cases showing 40-50% replacement the incidence of postoperative myxedema approached 70%.
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