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PATHOANATOMY > TUMORS OF PITUITARY GLAND > Flashcards

TUMORS OF PITUITARY GLAND Flashcards

(49 cards)

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1
Q

WHAT IS HYPERPITUITARISM?

A

over secretion of one or more of pituitary hormones

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2
Q

OUTLINE PIT. GLAND HORMONES?

A 
TSH
PROLACTIN 
FSH 
LH 
ACTH
GH 
ADH
OXYTOCIN
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3
Q

WHAT IS HYPOPITUITARISM

A

Deficiency of one or more pituitary hormone

TSH - hypothyroidism
ACTH - adrenal insufficiency
GH - dwarfism
LH + FSH - amenorrhea

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4
Q

WHAT IS ACROMEGALY

A

> IN ADULTS

EXCESSIVE PRODUCTION OF GH IN ADULTS AFTER CLOSURE OF EPIPHYSEAL PLATE IN BONE GROWTH

> increased growth of extremities - hands + feet
coarse facial features

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5
Q

ETIOLOGY OF ACROMEGALY

A

ADENOMA OF PIT. GLAND

tumors or somatotropin cells in anterior pit. gland

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6
Q

WHAT IS GIANTISM

A

> IN CHILDREN

EXCESSIVE SECRETION OF GH IN CHILDREN PRIOR TO CLOSURE OF EPIPHYSEAL PLATE IN BONE GROWTH

> enlargement + thickening of long bones
increased height + enlarged thoracic cage

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7
Q

WHAT IS CUSHING DISEASE

A

EXCESSIVE SECRETION OF ACTH > INCREASES CORTISOL SECRETION OF ADRENAL CORTEX

> Bilateral adrenal cortical hyperplasia
increased level of ACTH

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8
Q

ETOILOGY OF CUSHINGS DISEASE

A

> Lesion in pit. gland
corticotrophin adenoma
multiple micro adenomas

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9
Q

CLINICAL FEATURES OF CUSHINGS DISEASE

A 
> obesity + round belly 
> increased protein break down 
> systemic hypertension 
> impaired glucose tolerance > diabetes 
> hump back > adipocyte deposition 
> increased hair growth 
> moon round face
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10
Q

DESCRIBE GROSS ANATOMY OF PIT. GLAND ADENOMA

A

> 10mm to few cm in diameter
spherical
soft
encapsulated > BENING

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11
Q

DESCRIBE HISTOLOGY OF PIT. GLAND ADENOMA

A

3 PATTERN TYPES:
> DIFFUSE
polygonal cells arranged in sheets w/ scanty storm

> PAPILLARY
columnar/ fusiform cells arranged in papillae

> SINUSOIDAL
columnar/ fusiform cells w/ fibrovascular stroma

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12
Q

WHAT IS PITUITARY DWARFISM?

A

SEVERE DEFICIENCY OF GH IN CHILDREN BEFORE GROWTH IS COMPLETED
> retarded growth
> pituitary dwarfism

INHERITED AUTOSOMAL RECESSIVE DISORDER

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13
Q

CLINICAL FEATURE OF PITUITARY DWARFISM

A 
> proportionate retardation growth in bones 
> normal mental state of age 
> poorly developed genital 
> delayed puberty 
> episodes of hypoglycaemia
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14
Q

WHAT IS ADIPOSE GENITAL DYSTROPHY/ FROHLICH SYNDROME

A

> DECREASED LEVEL OF GONADOTROPIC RELEASING HORMONE
results > low FSH + LH

CAUSE:
> lesion in hypothalamus/ ant. pit. gland 
> craniopharyngioma
> adenoma 
> glioma
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15
Q

CLINICAL SYMPTOMS OF ADIPOSE-GENITAL DYSTROPHY/ FROHLICH SYNDROME

A

> disturbed growth
obesity
arrested sexual developement
mentally subnormal

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16
Q

WHAT IS SHEEHAN SYNDROME

A

> severe blood loss in female during birth labour
hypoxic damage to pit. gland
postpartum pituitary necrosis
enlarged pit. gland during pregnancy can be followed by hypotensive shock after birth > leading to necrosis

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17
Q

CLINICAL MANIFESTATION OF SHEEHAN SYNDROME?

A 
> failure of lactation following delivery > prolactin deficiency 
> loss axillary + pubic hair 
> amonerrhea 
> sterility 
> loss of libido
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18
Q

WHAT IS DIABETES INSIPIDUS

A

DEFICIENCY OF ADH DUE TO INFLAMMATION OR NEOPLASTIC LESIONS IN HYPOTHALAMIC-HYPOPHYSEAL AXIS

CAUSE:
> surgery lesions
> radiation therapy

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19
Q

CLINICAL FEATURES OF DIABETES INSIPIDUS

A

ADH acts on collecting duct to reabsorb water
Low ADH > no reabsorption of water > water loss

> large volume of urine 
> polyuria 
> polydipsia 
> dehydration 
> hypotension
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20
Q

WHAT IS CRANIOPHARYNGIOMA

Study These Flashcards
A

BENING TUMOR ARISING FROM REMENANTS OF RATHKES POUCH

> MC : CHILDREN + YOUNG ADULTS

> BENING TUMOR > compresses against adjacent structures

GROSS: 
encapsulated
adherent to surrounding structures
cystic
reddish-grey mass

HISTOLOGICALLY:
resembles ameloblastoma of jaw
stratified squamous epithelium
solid ameloblastous areas

HYDROCEPHALUS > build up of fluid > increased intra-cranial pressure > HEADACHE

DEFICIENCY IN HORMONE:
> GH
> GONADOTROPIN

21
Q

DEFINE GOITRE?

Study These Flashcards
A

ENLARGEMENT OF THYROID GLAND DUE TO HYPERPLASIA OF FOLLICULAR EPITHELIUM IN RESPONSE TO DEFICIENCY OF THYROID HORMONES

> swelling of thyroid gland > seen as lump in neck

MAIN ETIOLOGY:
Thyroid gland becomes hyper plastic due to deficiency of thyroid hormone + tries to compensate the deficiency
main reason for deficiency: LOW IODINE DIET

22
Q

EXPLAIN HOW DEFICIENCY THYROID HORMONE CAUSES HYPERPLASIA OF THYROID GLAND?

Study These Flashcards
A 
> deficiency thyroid hormone 
> activating negative feedback loop
> causing excessive secretion of TSH
> TSH act on thyroid glands
> hyperplasia of follicular epithelium 
> formation of new follicular cells
> enlarged/ swollen thyroid glands > GOITRE \
23
Q

WHAT IS ENDEMIC GOITRE?

Study These Flashcards
A

When significant proportion of population in area (more than 10%) has palpable/ obvious enlarged thyroid gland/ goitre

> usually due to IODINE DEFICIENCY
CHINA + AFRICA

24
Q

WHAT IS SPORADIC/ NON-ENDEMIC GOITRE?

Study These Flashcards
A 
Nothing to do with epidemiology
> due to low iodine diet 
> genetic factors 
> dietary goitrogens ( substances in food that cause dysfunction of thyroid - unable to produce T-hormones)
> hereditary defect
25
OUTLINE MORPHOLOGICAL FORMS OF GOITRE?
``` SIMPLE GOITR > enlargement of thyroid gland is: - moderate - symmetric - diffuse - cut surface > gelatinous + brown > HISTOLOGY: - large follicles distended by colour + lined by flattened epithelium ``` NODULAR GOITRE > asymmetric + extreme enlargement of thyroid gland - nodular with poor encapsulation - scarring - haemorrhages - cystic degeneration - focal calcification > HISTOLOGY: - partial/ incomplete encapsulation of nodules - small to large follicles > vary in size - follicles lined with flat to high epithelium - areas with haemorrhages, microcyst and calcification
26
WHAT IS HYPERTHYROIDISM
THYROTOXICOSIS/ GRAVES DISEASE > BASEDOW'S DISEASE > hyper metabolic + biochemical state due to excessive production of thyroid hormones TRIAD FEATURES: > hyperthyroidism > diffuse thyroid enlargement > ophtalmopathy MOST COMMON IN FEMALES 30-40 y/o
27
WHAT IS GRAVES DISEASE
AUTOIMMUNE DISORDER > EXCESSIVE PRODCUTION OF THYROID HORMONES > auto antibodies against thyroid antigens found in serum > Ab: - TSH receptor antibodies - Thyroid microsomal antibodies
28
GROSS ANATOMY OF THYROID IN GRAVES DISEASE
MODERATLEY, DIFFUSLEY + SYMMETRICALLY ENLARGED CUT SURFACE: - parenchyma is homogeneous + red brown + meaty
29
HISTOLOGY OF THYROID IN GAVES DISEASE
> epithelial hyperplasia > increased heigh of follicular lining cells > formation of papillary inholdings into lumina of follicles > colloid diminished + watery + vacuolated > stroma shows increase vascularity + accumulation of lymphoid cells
30
WHAT IS HYPOTHYROIDISM?
HYPOMETABOLIC CLINICAL STATE DUE TO INSUFFICIENCY PRODUCTION OF THYROID HORMONES FOR PROLONGED PERIODS 2 TYPES OF CLINICAL MANIFESTATION: > CRETINISM > MYXOEDEMA
31
OUTLINE 2 CLINICAL TYPES OF HYPOTHYROIDISM?
1. CRETISM | 2. MYXOEDEMA
32
EXPLAIN CRETINISM HYPOTHYROIDISM?
CONGENITAL HYPOTHYROIDISM > severe deficiency in thyroid hormones in new borns > impaired neurological functions: deaf mutism, spasticity, mental deficiency > stunted growth > physical deformities - thyroid agenesis > fetal exposure to antithyroid drugs + iodides > impaired skeletal growth > dwarfism > round face > narrow forehead > widely set eyes > flat broad nose
33
EXPLAIN MYXOEDEMA HYPOTHYROIDISM?
SEVERELY ADVANCED HYPOTHYROIDISM > non pitting edema due to accumulation of hydrophilic mucopolysaccharides in intercellular substance of dermis + other tissue CAUSE: - ablation of thyroid by surgery/ radiation - autoimmune thyroiditis CLINICAL FEATURES: - cold intolerance - mental + physical lethargy - constipation - slow of speech - intellectual function - puffiness of face - loss of hair - altered texture of skin
34
OUTLINE TYPES OF TUMORS OF THYROID GLAND
BENING: - Follicular Adenoma MALIGNANT: - Thyroid carcinoma
35
DESCRIBE GROSS ANATOMY OF THYROID ADENOMA
> most adenoma - asymptomatic with cold nodule > some hyperthyroidism with hot nodule - producing excessive thyroid hormones ``` > small + spherical shape > cut surface: - grey-white to red brown colour - focal area w/ calcification - haemorrhage + cyst formation ``` > solitary nodule - well define + round > complete encapsulation > clearly distinct inside + outside > compression of thyroid parenchyma
36
DESCRIBE HISTOLOGICAL APPEARANCE OF THYROID ADENOMA
BENING FOLLICULAR EPITHELIAL CELLS ARRANGED IN 4 TYPES: 1) Normofollicular - simple 2) Macrofollicular - colloid 3) Microfollicular - fetal 4) Trabecular - embryonal
37
WHAT DO YOU CALL MALIGNANT TYPE OF THYROID CANCER?
THYROID CARCINOMAS
38
TYPES OF THYROID CARCINOMAS
1. PAPILLARY CARCINOMA 2. FOLLICULAR CARCINOMA 3. ANAPLASTIC CARCINOMA 4. MEDULLARY THYROID CARCINOMA - SQUAMOUS CELL CARCINOMA - MUCOEPIDERMOID CARCINOMA - MUCINOUS CARCINOMA
39
EXPLAIN HYPERPARATHYROIDISM?
Excessive production of parathyroid hormone TYPES: - primary - secondary - tertiary
40
ETIOLOGY, BIOCHEMICAL TEST AND CLINICAL FEATURE OF PRIMARY HYPERPARATHYROIDISM
``` ETIOLOGY: > postmenopausal women > adenomas > carcinomas > hyperplasia ``` ``` BIOCHEMICAL TESTS: > increased parathyroid hormone > hypercalcemia > hypophophatemia > hypercalcuria ``` CLINICAL FEATURE: > lithiasis > nephrocalcinosis > metastatic calcification in blood vessels, kidneys, stomach, lungs
41
ETIOLOGY, BIOCHEMICAL TEST AND CLINICAL FEATURE OF SECONDARY HYPERPARATHYROIDISM
ETIOLOGY: > chronic renal failure > vitamin D deficiency > malabsorption syndromes BIOCHEMICAL TESTS: > hypocalcemia ``` CLINICAL FEATURE: > renal osteodystrophy > osteoporosis > osteomalacia > osteosceloriss ```
42
ETIOLOGY OF TERTIARY HYPERPARATHYROIDISM
Hyperplastic autonomous
43
WHAT IS HYPOPARATHYROIDISM?
DEFICIENCY OF PARATHYROID HORMONE
44
TYPES OF HYPOPARATHYROIDISM?
Primary hypoparathyroidism Pseudohypoparathyroidism Pseudo-pseudohypoparathydoisim
45
RISK FACTORS FOR PARATHYROID ADENOMA
> any age > males + female equally > later age
46
CLINICAL FEATURE OF PARATHYROID ADENOMA
HYPERPARATHYROIDISM
47
GROSS ANATOMY OF PARATHYROID ADENOMA
> less than 5cm in diameter > yellow/ brown > round > encapsulated
48
MICRO DESCRIPTION OF PARATHYROID ADENOMA
> chief cells arranged in sheets/ cords > oxyphil cells + water clear cells > parathyroid parenchyma external to capsule >> helps to differentiate adenoma from diffuse hyperplasia
49
DESCRIBE GROSS AND MICRO ANATOMY OF PARATHYROID CARCINOMA
> rate tumor > severe hyperparathyroidism GROSS: - irregular shape - adherent to surrounding tissue MICRO: - well differentiated adenocarcinoma

PATHOANATOMY (7 decks)

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