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Endocrine Pathology > CP53 - Endocrine Pathology > Flashcards

CP53 - Endocrine Pathology Flashcards

1
Q

How does endocrine gland work?

A

secrete hormones directly into the blood stream and act systematically

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2
Q

How does paracrine system work?

A

secrete hormones which act locally

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3
Q

how does autocrine system work?

A

affect the cell which secrete the protein

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4
Q

what id the pituitary gland located?

A

situated in the sella turcica beneath the hypothalamus

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5
Q

what are the 2 parts of the pituitary glands?

A

anterior (75%) & posterior (25%)

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6
Q

what are some of the causes of adenohypophysis hypofunction?

A

most common tumours - non-secretory adenoma (more common), metastatic carcinoma, but also trauma, infraction, inflammation etc (anything which causes compression on the sella turcica

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7
Q

what is the name of the anterior part of the pituitary gland?

A

adenohypophysis

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8
Q

what is the name of the posterior part of the pituitary gland?

A

neurohypophysis

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9
Q

are primary pituitary tumors mostly benign or malignant?

A

most are adenomas and hence benign

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10
Q

where within the pituitary glands can primary cancer arise?

A

from any hormone producing cells within the pituitary gland

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11
Q

what are the clinical effect of the tumors if they are functional?

A

secondary to hormones being produced eg acromegaly

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12
Q

what is the local effect of pituitary tumors

A

pressure on optic chiasma/ adjacent pituitary cells

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13
Q

what are the different types of adenohypophysial adenoma?

A
  • prolactinoma - commonest, galactorrhea (milky nipple dischange unrelated to normal breast milk) & menstrual disturbance
  • growth hormone secreting - gigantism (unusually largeness) in children and acromegaly in adults
  • ACTH secreting - Cushing’s syndrome
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14
Q

thyroid anatomy?

A

bilobed organ joined by isthmus encased in thin fibrous capsule located at the level of 5th, 6th and 7th verterbra in the anterior neck in close proximity to the trachea

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15
Q

what is ectopia?

A

tissue present in a place where it does not belong

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16
Q

what is heterotopia

A

tissue present in a place where it does not belong due to displacement

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17
Q

what is the function of thyroid glands

A

produce iodinated amino acid thyroxine (T4) & iodothyronine (T3)

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18
Q

where is the most common ectopia of thyroid?

A

lingual thyroid - usually at the base of tongue

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19
Q

what is thyroglossal duct cyst

A

it is persistent track representing the embryological migratory path of thyroid anlage in the anterior neck

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20
Q

what is acute thyroiditis?

A

acute inflammatory of the thyroid parenchyma associated with local/systemic viral, bacterial or fungal infection, most cases due to generalised sepsis

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21
Q

what is palpation thyroiditis

A

microscopic granulomatous foci centered on thyroid follicles - secondary to rupture of thyroid follicles due to palation or suregery

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22
Q

what is reidel thyroiditis

A

rare fibrosing form of chronic thyroiditis, present with firm goitre

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23
Q

what is Hashimoto’s thyroiditis?

A

it is chronic lymphocytic thyroiditis - an autoimmune chronic inflammatory disorder associated with diffuse enlargement and thyroid autoantibodies.

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24
Q

what is the presentation of Hashimoto’s thyroiditis

A

diffusely enlarged non-tendered gland, serum thyroid antibodies elevated

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25
Q

what is the charactersitic of Hashimoto’s thyroiditis histologically?

A

infiltration of lymphocytes and plasma cells.

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26
Q

what happen to the functioning level of the thyroid of the patients with Hasimoto’s thyroiditis

A

hypothyroidism

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27
Q

what conditions are patients with Hashimoto’s thyroiditis more at risk of?

A

thyroid lymphoma, papillary carcinoma of thyroid

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28
Q

what is Graves’ thyroiditis

A

it is diffuse hyperplasia - an autoimmune process results in clinical hypothyroidism and diffuse hyperplasia of the follicular epithelium.

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29
Q

what are some of the physical findings for Graves’ thyroiditis

A

diffuse goitre, pretibial myxoedema, hair loss, wide-eyed stare/proptosis/exophthalmos (protruding of eyeball) , tachycardia, hyperactive reflexes

30
Q

what are some of the clinical findings of Graves’ thyroiditis?

A

T3 & T4 elevated, TSh markedly suppressed, present of thyroid autoantibodies, especially thyroid stimulating immunoglobulin.

31
Q

what are the histopathological findings for Graves’ thyroiditis?

A

thyroid gland show hyperplasia of the acinar epithelium, reduction of stored colloid and local accumulations of lymphocytes.

32
Q

why does Hashimoto’s thyroiditis cause hypothyroidism?

A

lymphocytic infiltration and thyroid cells undergoes atrophy

33
Q

what precentage of patients with hypothyroidism have Graves’ Disease?

A

80%

34
Q

what is multinodular goitre?

A

enlargement of thyroid with varying degrees of nodule involved

35
Q

what does the level of thyroid function of patients with multinodular goitre have ?

A

normal - euthyroid

36
Q

what are some of the complication for multinodular goitre?

A

tracheal compression or dysphagia

37
Q

what is follicular adenoma of thyroid

A

benign encapsulated tumor with evidence of follicular differentiation

38
Q

what is the usual presentation for follicular adenoma of thyroid

A

painless neck mass - often present for years, solitary nodule involving only one lobe

39
Q

what are the different subtype of carcinoma in the htyroid?

A

papillary, follicular, anaplastic, medullary

40
Q

what is the commonest thyroid carcinoma?

A

papillary carcinoma

41
Q

what are the macroscopic appearance of pappillary carcinoma ?

A

ill defined, infiltrative, some encapsulated, maybe cystic, granular

42
Q

what are the subtype of follicular carcinoma?

A

follicular adenoma, minially invasice follicular carcinoma, widely invasive follicular carcinoma, hurthle ell neoplasms

43
Q

what are some of the presentation of follicular carcinoma?

A

90% - present with solitary nodule in thyroid

44
Q

what are the 2 types of follicular carcinoma?

A

minimally invasive & widely invasive ( they have different prognosis 7 different degree of metastasis )

45
Q

what classify minially invasive & widely invasive follicular carcinoma

A
  • Minimally invasive – Completely encapsulated. Invasion only detectable histologically
  • Widely invasive – Macroscopic evidence of invasion. Widespread invasion histologically.
46
Q

what is the characteristic of Hurthle Cell Carcinoma

A

large acidophilic cells in canine thyroid

47
Q

what are the clinical presentation of hurthle cell carcinoma?

A

high incidence of cervical lymph node metastases

48
Q

what are the 3 differentiated thyroid carcinoma?

A

papillary, follicular & Hurthle cell carcinoma

49
Q

what are poorly differentiated thyroid carcinoma?

A

insular carcinoma, anaplastic carcinoma, medullary carcinoma, lymphoma

50
Q

what are characteristic of anaplastic carcinoma?

A

rapdily enlarging thyroid mass, long history of goitre,

51
Q

what is the characteristic of medullary carcinoma?

A

malignant tumor showing differentiation to parafollicular C cells - 80% sporadic, 20% - autosomal dominant inherited (MEN2a&2b)

52
Q

what is primary thyroid lymphoma

A

primary lymphoma arisisng within the thyroid glnad often associated with lymphocytic thyroiditis,

53
Q

what is lymphoma ?

A

malignancy within the lymphocytes and can generally be sub-catogrise into 2 types eg Hodgkin & non-Hodgkin lymphoma

54
Q

what is the characteristic of primary thyroid lymphoma

A

mass in thyroid, often associate with rapid enlargement, pain, dysphagia, may have assoicated cervical lymphadenopathy

55
Q

can MEN 2A cause hyperthyroidism?

A

yes

56
Q

what is primary chief cell hyperplasia

A

non-neoplastic increase in parathyroid tissue without a known stimulus - can cause hyperparathyroidism

57
Q

what is parathyroid adenoma?

A

an encapsulated benign neoplasm of parathyroid cells, has symptoms of hypercalaemia, associated with MEN 1 & MEN 2, hyperparathyroidism

58
Q

what is parathyroid carcinoma

A

malignant tumour derived from parathyroid parenchymal cells, symptoms referable to excess Ca2+

59
Q

what is Addison’s Disease

A

primary adrenal cortical insufficiency caused by adrenal dysgenesis, adrenal destruction

60
Q

Which form of Addison’s Disease is more common

A

autoimmune form most common & tuberculosis more common in developing world

61
Q

what are the 3 most common characteristic of Addison’s Disease?

A

Triad of hyperpigmentationm postural hypotension & hyponatraemia

62
Q

what is the treatment of Addison’s Disease?

A

long term steroid replacement therapy

63
Q

what is adrenal cortical adenoma?

A

benign neoplastic proliferation of adrenal cortical tissue

64
Q

what are the symptoms of adrenal cortical adenoma?

A

related to endocrine hyperfunction - hypertension, Cushing’s snydrome and virilisation (secondary sexual characteristic development).

65
Q

what can aldosterone-producing tumour cause?

A

Conn’s Syndrome

66
Q

what is adrenal cortical carcinoma?

A

malignant counterpart of adrenal adenoma

67
Q

what are some of the common symptoms of adrenal cortical carcinoma?

A

related to hormone excess, abdominal mass,

68
Q

what is phaeochromocytoma

A

catecholamine secreting tumour arising from adrenal medulla

69
Q

what is catecholamine

A

norepinephrine & dopamine

70
Q

what are some of the causes of phaeochromocytoma?

A

sporadic & familial syndromes MEN 2A & 2B

71
Q

what are some clinical observation of phaeochromocytoma

A

elevated urine catecholamines, adrenaline, noradrenaline

Endocrine Pathology (5 decks)

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