Pathogenesis of Cirrhosis of the Liver Occurring in Patients With Diffuse Toxic Goiter

FROM THE standpoint of morphology, the liver has received abundant attention in fatal cases of diffuse toxic goiter. The lesions found are various; there are fatty changes, parenchymatous degeneration, venous congestion and, finally, cirrhosis of such a distinctive character as to be pathognomonic of this disorder. These lesions occur singly or in various combinations. In an appreciable percentage of cases no lesion of the liver is found. Acute yellow atrophy has been reported by Raab and Terplan,1Kerr and Rusk,2Zeldenrust and van Beek3and Beaver and Pemberton.4Foci of necrosis have been reported by Beaver and Pemberton,4Habán,5Rössle6and Cameron and Karuntaratne.7Whether focal necrosis represents an early or an abortive phase of acute yellow atrophy is questionable. Beaver and Pemberton found focal necrosis in 6.5 per cent of the livers of 107 patients afflicted with diffuse toxic goiter; in 5 patients the necrosis was of sufficient intensity to be