Hemorrhagic Cysts of the Thyroid Gland 1896
W.I.Bradley McGill University
Comment: The etiology of cysts was looked at in the this paper from 1896. We see thyroid cysts today, but we do not have to operate on cysts like they did for 100 years. Ethanol ablation treats the cyst without surgery today. One cyst had papillary projections into the lumen. Today we would be worried that that was a cystic papillary thyroid cancer. Large cysts have a higher incidence of cancer that solid thyroid nodules.4-5% vs 15-19%.
Richard Guttler MD,FACE,ECNU
The 18th century term for solid enlarging goiter was bronchocele. The cause was over-production and retention of colloid. The other is a localized solitary cyst with a different content that a Bronchocele (goiter).Out of 18 cases of goiter operated at McGill on 9/18 were cysts.
- Orange shaped mass with reddish brown fluid.
- Two cysts with thick greenish-brown fluid.
- Lemon sized cyst with papillary projections into the lumen of the cyst ( thyroid cancer?)
- Hen’s egg sized cyst with yellow-brown fluid.
- Orange sized cyst with straw colored fluid.
- Turnip sized cyst with dark brown fluid.
- Grapefruit sized cyst with dark-yellow fluid.In 1896 it was felt that the cyst was caused by destruction of the inside of the goiter or bronchocele with hemorrhage into a space.
- The thyroid goiter has frequent sites of hemorrhage as the cause of these large cysts.
- These cysts occur in thyroid glands that are already abnormal with goiter formation.
- The cyst is never all alone in a normal thyroid gland.
- Photomicrograph is from a cyst with extensive hemorrhage showing rupture of thyroid tissue. Blood is bordered by ruptured follicles called vesicles in 1986.