Pathology of the thyroid gland Flashcards Preview

Year 2 Endocrine > Pathology of the thyroid gland > Flashcards

Flashcards in Pathology of the thyroid gland Deck (24):
1

hyperthyroidism: symptoms and signs

- hypermetabolism
- enhanced EPI effect
- lid lag - delay in downward movement of upper eyelid
- ATRIAL FIBRILLATION
- thyroid storm

2

graves disease: pathophysiology

production of IgG antibody directed against TSH receptor called TSH receptor autoantibodies (TRAb)

3

graves disease: thyroid hormone levels

high T3
high T4
low TSH

4

patients presenting with myxedema must also present with what feature in order to have a diagnosis of HYPERthyroidism?

nodules

5

hyperthyroidism: thyroid gland gross appearance

diffuse, symmetrical beefy red gland

6

hyperthyroidism: histology

- hyperplastic follicles with papillary infoldings
- pale colloid with resportion vacuoles ("scalloping")

7

definition: myxedema

it is USUALLY associated with what thyroid disorder?

accumulation of hyrophilic ground substance (amorphous gel-like substance) throughout the CT of the body

hypothyroidism

8

definition: cretinism

what are the distinctive features?

hypothyroidism presenting first in infancy or childhood

facial swelling
puffy eyelids
protruding tongue
low hair line
altered eyebrows

9

screening for hypothyroidism must occur before what time period?

3rd week

10

definition: hashimoto thyroiditis

chronic progressive thyroid disease - deficiency in Treg cells

increase in cytotoxic T cells and activated B cells

11

pathogenesis: hashimoto thyroiditis

HLA Dr5 (check recording)

12

gross appearance: hashimoto

diffusely enlarged

13

histology: hashimoto

- mononuclear inflammatory infiltrates
- well developed germinal centers
- thyroid follicles are atrophic and are lined in many areas by epithelial cells distinguished by the presence of Hurthlecells

14

Hurthle cells

- abundant eosinophilic granular cytoplasm
- metaplastic response of the normally low cuboidal follicular epithelial cells to ongoing injury

15

de quervain thyroiditis: definition and symptoms

secondary to a viral infection by mumps, adenoviruses, echo, coxsackie

- painful 40-50 yo, F/M 4:1
- acute febrile onset with acute enlargement of the gland
- increased ESR
- transient increase in T3/T4 and decrease in TSH
- transient hyperthyroidism weeks to months self resolves

16

de quervain thyroiditis: pathology

granulomas with giant cells, macrophages, lymphocytes, and destroyed thyroid follicles

17

multinodular goiter: pathology

- colloid rich follicles of varying sizes with FLATTENED epithelium
- nodules, hemosiderin, hemorrhage, calcification

18

thyroid tumors: cold nodules

palpable mass lesions that failr to take up radiolabeled iodine during nuclear scans

19

thyroid tumors: hot nodules

palpable mass lesions that are hyperfunctioning and accumulate increased amounts of radioiodine relative to surrounding normal during scan

20

thyroid adenoma

is it malignant or benign?

solitary, spherical encapsulated lesino that is demarcated from surrounding thyroid parenchyma by a well defined intact capsule

always benign, no chance to turn malignant

21

thyroid cancer: tumor type prevalence and prognosis

papillary - 65% - great
follicular - 25% - 50/50
medullary - 5% - 50/50
anaplastic - 5% - high mortality

22

papillary adenocarcinoma: gross appearance and histology

fibrovascular stalk with tumor cells

- orphan annie eye nuclei (marginated chromatin and optically clear centers - fixation artifact)
- psammoma bodies
- intranuclear cytoplasmic inclusion (INCI) aka nuclear hole
nuclear grooves aka coffee bean nucleus

23

follicular thyroid carcinoma

more aggressive

24

medullary thyroid carcinoma

cancer of differentiating C cells
RET protooncogenes