Endocrine Disease - Pathology Flashcards
Endocrine gland is…
One whose secretions (hormones) pass directly into bloodstream
Hormones
Function
Mechanism - where are receptors
Influence target organs to secrete e.g
Bind to receptors
May be on cell surface or intranuclear
Exocrine gland is …
One whose secretions pass into gut, respiratory tract or exterior of body
Normal adrenals
4g each
2-6g in sudden death autopsies
Cortex makes up 90% of weight
Causes of hypocorticalism
How does adrenal failure occur
Pituitary disease
Adrenal failure
Haemorrhage necrosis, autoimmunity, destruction by TB or tumour, suppression due to steroid tx
Effects of hypocorticalism
Skin pigmentation Hypotension Muscle weakness Hypoglycaemia Hyponatraemia Hyperkalaemia Renal dysfunction
Diseases associated with hypercorticalism
Cushing’s syndrome
Cushing’s disease
Conn’s syndrome
Adreno-genital syndrome
Effects of Cushing’s syndrome
Weight gain Osteoporosis Hyperglycaemia Myopathy Skin atrophy Polycythaemia Susceptibility to infection Goiter
Phaeochromocytoma
Results in
Neuroendocrine tumor of the medulla of the adrenal glands. Contains chromatin cells
- secretes high amounts of catecholamines, mostly norepinephrine, plus epinephrine to a lesser extent.
Paroxysmal (sudden) hypertension
Extra-adrenal paragangliomas
Less common
tumors that originate in the ganglia of the sympathetic nervous system
are named based upon the primary anatomical site of origin.
Associations of phaechromocytoma
Familial - autosomal dominant Neurofibromatosis Von Hippel-Lindau disease Medullary carcinoma of the thyroid Parathyroid adenomas
Behaviour of phaeochromcytoma
Most benign
5-10% malignant
Metastasise to lymph nodes, lungs, liver and bone
Benefits of cytology
Cons
Safe
Reduced need to excise lesions
Can establish diagnosis of some types of carcinoma
Cant distinguish between benign and malignant follicular lesions
thyroid disease manifests as
Masses
Malfunction
Thyroid masses can be
Cysts
Dominant nodule in multi nodule goitre
Benign neoplasms
Malignant neoplasms
Benign neoplasms
Character
Capsule?
More…?
Follicular adenoma
Usually solitary
Encapsulated
More common than malignant
Malignant neoplasms
Different types
Papillary Medullary Follicular Anaplastic Lymphoma
Papillary carcinoma
Stats
Who does it affect
Mechanism of spread
Prognosis
60-70% of cases
Children and young adults
Lymphatic spread
Excellent prognosis
Follicular carcinoma
Stats Who does it affect Mechanism of spread Prognosis Differentiation
20-25% cases
Young-middle aged
Bloodstream
Good prognosis
Varying degrees, some areas more differentiated than others
Vascular invasion
Histological image
When neoplasm invades vascular structures
Growth enters vessel space
Medullary carcinoma Stats Who does it affect Mechanism of spread Prognosis
Growth pattern
5-10% of cases
Elderly
Lymphatic and blood stream
Variable prognosis
Varied
Anaplastic carcinoma Stats Who does it affect Mechanism of spread Prognosis
10-15% cases
Elderly
Aggressive local spread
Very poor prognosis
Lymphoma
Different types
Which is more treatable
Commonest cause of lymphoma
Hodgkin’s/Non-Hodgkins
Mucosa associated lymphoid tissue diseases
Hodgkin more treatable
Hashimoto’s thyroiditis (goitre)
Infra-thyroidal metastasis
Examples
Metastatic colonic carcinoma
