Editing Goitre (section)

== '''Non-toxic multinodular goitre''' ==

* Epidemiology
** Most common cause of      non-toxic goitre in non-iodine deficient countries
** Incidence about 5%
* Risk factors
** Can be associated with      iodine deficiency
** Genetic
** Smoking
** Autoimmune disease
** Malignancy
* Aetiology
** Chronic autoimmune      thyroiditis
** Graves
** Tumours
** Thyroiditis
** Infiltrative diseases
** TSH secreting pituitary      tumours
** Thyroid hormone resistance
* Pathophysiology
** True pathophysiology is not      known very well
** Impaired synthesis of      thyroid hormone - leads to compensatory rise in serum TSH, which results      in repeated instances of stimulation and involution of thyroid follicular      cells
** Macrofollicular nodules - a      combination of monoclonal adenomas and colloid nodules
** Microfollicular adenomas are      follicular neoplasms which can only be differentiated from follicular      carcinomas by their lack of capsular or vascular invasion