Gross Appearance
In Hashimoto's disease, thyroid enlargement is symmetrical, often with a characteristic conspicuous pyramidal lobe. Although the gland is symmetrically enlarged, the accentuation of lobulations may make the gland appear lobular on gross examination.
The tissue involved by Hashimoto's thyroiditis is pinkish-tan (Figure 1) to frankly yellowish (Figure 2) in color and tends to have a rubbery firmness. There is no necrosis or calcification.
The capsule is intact and the capsular surface is gently lobulated and non-adherent to peri-thyroid structures i.e. the gland itself is still distinct from surrounding tissue. It may have adhesions but thyroid gland is easily separated from other structures
Figure 1. Hashimoto's thyroiditis. Note the symmetrical enlargement of the gland and the pinkish-tan
Figure 2. Hashimoto's thyroiditis. Note the symmetrical enlargement of the gland and the yellowish discoloration.