The prevalence of unsuspected thyroid pathology in 300 sequential autopsies, with special reference to the incidental carcinoma

Pathology normally comes to the attention of the physician in the form of illness. Occasionally, however, pathological changes are identified at autopsy and reveal diseases for which there were no clinical symptoms. This may be especially true of pathology of the thyroid gland, which generally gets little attention at postmortem examination. To determine the incidence of thyroid pathology in patients who had no evidence of thyroid disease, 300 whole thyroids were obtained sequentially at autopsy; the only selection characteristic being no clinical evidence of thyroid disease. The patients ranged from 13 to 82 years of age; 75.8 percent were between their fourth and seventh decade. Males outnumbered females two to one in this sample. The glands were fixed in formalin and subjected to routine histological analysis. In 6.6 percent there was some sort of thyroid tumor evident. A total of seven malignancies were identified, representing 2.3 percent of the sample; five of these seven were seen in otherwise normal thyroid glands. Less than half (42.3 percent) of the thyroid glands were normal. Colloid goiter and thyroiditis were the most frequently observed conditions. Clearly, an apparently normal thyroid gland not only may have hidden pathology, but is indeed likely to have hidden pathology. (Consumer Summary produced by Reliance Medical Information, Inc.)