[Diagnosis of Hashimoto's disease by multiple biopsy].

The author attempted to realize the accuracy and limitation of the operative biopsy for the diagnosis of Hashimoto's disease. In the 11 cases of total—partial thyroidectomy , there was no essential difference between the histological types of both thyroid lobes. The diagnosis of Hashimoto's disease was obtained in 81 % by single biopsy (a tiny specimen from one lobe through a small incision). The histological type was, however, discernible only in less than 50% and other associated thyroid diseases, preoperatively unnoticed , were not found by single biopsy. In contrast, by multiple biopsy (specimens from both thyroid lobes after exposure of the whole thyroid gland) the diagnosis of Hashimoto's disease was obtained in 100%. The histological type was discernible in 71% and out of 21 cases the association of other types of thyroid diseases; 1 case of papillary cancer and 4 cases of adenoma were revealed by mutliple biopsy. On the basis of the reasons mentioned above, single biopsy was not to be recommended, either to determine the histological type of Hashimoto's disease, to search for the other types of thyroid diseases or to diagnose the thyroiditis associated with Graves' disease or simple diffuse goiter. Judging from the clinical and laboratory data, the characteristic findings of Hashimoto's disease were most typically shown by diffuse thyroiditis, and were followed by focal thyroiditis grade (3) *, diffuse thyroiditis with marked fibrosis, and focal thyroiditis grade (2) * in this order. It might be justifiable to exclude, at least clinically, focal thyroiditis grade (2) from the category of Hashimoto's disease and/or chronic thyroiditis, according to the fact that focal thyroiditis grade (2) hardly shows any clinical and laboratory findings of Hashimoto's disease, including swelling and change in consistency of the thyroid gland, and could be mainly manifested as an associated form rather than as a single form. However, it might also to be kept in mind that focal thyroiditis grade