CRAW (struma) — visible enlargement of the thyroid gland. 3. also the wedge, a picture is one of the leading symptoms of a number of diseases with various etiology (see. Craw diffusion toxic , Craw sporadic , Craw local ). The concept «craw» (struma) is entered by A. Galler. It is reasonable to use the term «craw» for designation of the enlargement of the thyroid gland which is initially connected with activation of proliferative and hypertrophic processes in its parenchyma, but not changes of the sizes of body caused by inflammatory process, a new growth, hemorrhage and also cases of increase in the sizes of gland caused by a hyperplasia lymphoid (Hashimoto's disease) or connecting (Ridel's craw) of fabric (see. Hashimoto disease , Thyroiditis ). The enlargement of the thyroid gland can be inborn, periodically be observed in the pubertal period (3. youthful), at pregnancy (3. pregnant women).
The USSR allocates 5 degrees of an enlargement of the thyroid gland: 0 degree — a thyroid gland of a normal amount, at a palpation of a neck is not probed; The I degree — a thyroid gland is increased, the isthmus clearly is probed; The II degree — at a palpation is probed all thyroid gland, during the swallowing the isthmus, sometimes — side shares is swept up; The III degree — a visible enlargement of the thyroid gland («a thick neck»); The IV degree — sharply increased gland changes contours of a neck; The V degree — a craw of the huge sizes, as a rule, nodal, in certain cases hanging down over the surface of a neck in the form of a bag. To «true» 3. carry the III—V degrees of an enlargement of the thyroid gland (fig). Increases in I and II degrees are rather reversible, will easier respond to drug treatment, and at youthful age and at pregnancy have passing character. At assessment of size 3. circles of a front surface of a neck or the longitudinal and cross sizes 3 take also measurement.
Topography 3. it is various. In addition to usual localization in a neck, optional versions of an atypical arrangement 3., the development of a thyroid gland (an allotopia of gland) which is a consequence of anomalies, existence of an additional (aberrant) thyroid parenchyma. Also retrotracheal, intraezofagealny localizations are possible lingvalny, sublingual, retrosternal, mediastinal, pre-. 3. can be located in side departments of a neck, for grudino - a clavicular and mastoidal muscle, in submaxillary area etc.
See also Thyroid gland .
Bibliography: Nikolaev O. V. Local craw, M., 1955; The Guide to clinical endocrinology, under the editorship of V. G. Baranov, L., 1977, bibliogr.; The guide to endocrinology, under the editorship of B. V. Alyoshin, etc., M., 1973; Havin I. B. and H and to about l and e in O. V. Diseases of a thyroid gland, M., 1961; The Local craw, the lane with English, M., WHO, 1963; M e-and n s J. H., D e G r about about t L. J. a. S t a n-b u r y J. B. The thyroid and its diseases, N. Y., 1963; Oberdisse K. u. Klein E. Die Krankheiten der Schilddriise, Stuttgart, 1967. M. D. Donskova,
A. G. Mazowiecki.