CASE HISTORY

This patient first presented on 16.2.56. She was dull, apathetic and unable to give a history. There was a story of non-specific ill health for 30 years and a recent history of substernal pain. Thickening of facial features and hoarseness of the voice had been noticed for some years. On examination she presented the classical features of myxoedema. Investigations showed evidence of posterior cardiac infarction, raised plasma cholesterol, gall stones and a calcified mass in the right side of the abdomen. She was treated with tri-iodothyronine acetate 3.3ug tds and cortisone 25mg qid. Signs of acute cardiac failure developed almost immediately and the patient died on 10.3.56. At autopsy she was found to have old and recent myocardial infarction and Hashimoto's thyroiditis.

PATHOLOGY

This is a postmortem specimen showing the isthmus and most of the lateral lobes of the diffusely enlarged thyroid gland. The gland weighed 83g. Deep prolongations have almost encircled the trachea. The gland is smooth and encapsulated. There is no invasion of adjacent tissues. The cut surface is smooth, predominantly pinkish-grey, with small irregular yellow areas divided by connective tissue.