24.10 Path: Thyroid pathology Flashcards
What is a simple goitre the result of?
Stimulation by high TSH (euthyroid)- e.g. from iodine deficiency
What pathological changes do we see microscopically in simple goitre? (3)
- Hyperplastic, crowded cells
- Follicles of irregular size
- Some follicles with large amount of colloid
What changes do we see in simple goitre macroscopically (after many years)?
Fibrosis/haemorrhage in some follicles, proliferation=multinodular goitre
What does Hashimotos disease do?
Autoimmune destruction: hypothyroid
What do we see microscopically in Hashimoto disease? (4)
- Fibrous tissue
- Mononuclear cell infiltrate
- Changes in epithelial cells
- Germinal centres
What does Graves disease do?
Autoimmune stimulation: hyperthyroid
What microscopic changes do we see in Graves disease?
- Scalloping of colloid
- Pale colloid
- Lymphocytic infiltrate
- Tall, crowded epithelial cells (may form papillae)
What can thyrotoxicosis be caused by?
Overactive thyroid-tumour, Graves disease
What is considered endemic (%) in a population with goiter ?
Where do we see this?
> 10% of population
Often seen in Alps (less iodine in the soil)
What can be a sporadic reason for simple goitre?
Congenital predisposition and goitrogens
What can hypothyroidism do in children?
Developmental abnormalities, cretinism
What can happen to a simple goitre over time? How does this change their condition?
A multinodular goiter can be a TMNG
Nodules can become autonomous- may be hyperthyroid
What do we see on an NM scan with TMNG?
Nodule will be ‘hot’
What do we see in antibodies with Hashimotos vs. Graves?
Hashimotos: Anti TPO antibodies INCREASE (Thyroglobulin ABs increase somewhat)
Graves: Anti TPO Abs but TSI INCREASE
