Endocrine Pathology Flashcards by Stephanye Quinn

Kids that were born dead or died shortly after birth, weak with large neck “masses” some were hairless. What endocrine disorder would be at the top of your DDx?

Goiter

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Characteristic lesions associated with Diabetes Mellitus

Cataracts (Dogs Only)

Microangiopathy

Hepatic Lipidosis

Lesions caused by infections

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(Primary/Secondary) endocrine disorders involve decreased cellular activity or increased cellular activity of the endocrine gland.

Primary Endocrine Disorders

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Endocrine function of goiter

Euthyroid or Hypothyroid

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Endocrine function of Diabetes Mellitus

Hypoinsulinemia

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Pathogenesis of Diabetic Nephropathy

Chronic hyperglycemia
Formation of glycosylated proteins
Deposition into caplillary basement membranes
Thickened basement membrane (“microangiopathy)

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Pancreas: Morphological Diagnosis

Chronic Pancreatitis

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Morphological Diagnosis

Thyroid Hyperplasia

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Histological Appearance of

Adrenocortical Neoplasm

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(Primary/Secondary) Endocrine disorders consist of a lesion of another organ that leads to decreased or increased cellular activity of the endocrine gland

Secondary Endocrine Disorder

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Hypopituitarism causes what endocrine disorder?

Hypoadrenocortisim - Addison’s Disease

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Cause of Primary Hyperparathyroidism

PTH producing Parathyroid Neoplasm

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Insulin resistance can occur secondary to

Hyperadrenocorticism

Obesity

Pregnancy

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Pathogenesis of cataracts due to DM

Excessive glucose taken up by epithelium of the lens → metabolized to sorbitol by aldose reductase → sorbitol osmotically draws water into the lens → cataract formation

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Morphological Diagnosis

Adrenocortical Adenoma/Carcinoma

_____________________

Require histology to differentiate

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Pathogenesis of Islet Cell Vacuolar Degeneration

Insulin Resistance
Long term overstimulation of Beta-Cells
Intracellular accumulation of glycogen
Vacuolar degeneration of beta cells
Insulin deficiency and more severe diabetes mellitus

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Endocrine disorder that causes hypertension and polymopathy (due to hypernatriemia and hypokalemia)

Hyperaldosteronism - Conn’s Syndrome

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What dis?

Pheochromocytoma

__________________________

Would need to be differentiated from Adrenocortical Neoplasm with histopathology

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Lesion assoicated with what endocrine disorder?

Steroid Hepatopathy

Hyperadrenocorticism - Cushing’s Disease

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Histology of a pancreas from a cat with Diabetes mellitus due to:

Insulin Antagonism

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In horses, most pituitary adenomas are from where, and some produce ACTH.

Pars intermedia

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Lesions that may be associated with Hyperadrenocorticism

Adrenocortical Adenoma/Carcinoma

Steroid Hepatopathy

Calcinosis cutis

Pituitary Adenoma

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Endocrine disease that causes nodular thyroid hyperplasia. Characterized by increased appetite with weight loss, PU, enlarged nodular thyroids and histologically abnormal follicles.

Hyperthyroidism

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Histologic appearance of lesion associated with what endocrine disease?

Calcinosis cutis

Hyperadrenocorticism - Cushings Disease

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Histologic appearance of what lesion associated with what endocrine disease?

Steroid Hepatopathy Hyperadrenocorticism - Cushing's Disease

Possible causes of hyperadrenocorticism

Adrenocortical adenoma/ carcinoma ACTH secreting pituitary adenoma Adrenocortical hyperplasia Iatrogenic

Thyroid carcinomas can arise from what types of cells

Follicular Cells C Cells

Why might you see this lesion with secondary hyperparathyroidism?

PTH stimulates increased resorption of bone Chronic PTH stimulates bone marrow stromal cells to differentiate into fibroblasts High P and low vitamin D \> Low Ca \> inability to properly mineralize growing bown due to low Ca and uremic acidosis

Morphological Diagnosis

Nodular Thyroid Hyperplasia

Endocrine function of thyroid carcinomas

Euthyroid

What stimulates the parathyroid gland

Nutritional imbalance - high P and/or low Ca Renal Disease Lack of UVs and inadequate vitamin D3

Histologic Appearance of

Pheochromocytoma

Lesion caused by what endocrine disorder?

Fibrous Osteodystrophy Secondary Hyperparathyroidism

Pathogenesis of Islet Amyloidosis

1. Long term overstimulation of Beta cells 2. Beta cells produce IAPP (Islet Amyloid Polypeptide) along with insulin 3. IAPP polymerizes to form amyloid 4. Crowding of islet cells 5. Islet cell atrophy 6. Insulin deficiency and more severe diabetes mellitus

To differentiate between pheochromocytomas and adrenocortical neoplasms histology is required. However, grossly pheochromocytomas should have what kind of appearance.

Red and mottled

Endocrine disorder that causes hypertension and polymopathy due to hypernatremia and hypokalemia.

Conn's Syndrome

Histologic appearance of goiter. What is abnormal?

Lacks colloid

Morphological Diagnosis

Acute Cerebral Cortical Neuronal Necrosis

Diabetes Mellitus causes what histological appearance

Beta Cell Degeneration Beta Cell Amyloidosis Islet-itis Chronic Pancreatitis

Primary Hypoadrenocorticism is caused by

Adrenocortical Atrophy

Lesion of a dog with diabetes mellitus

Diabetic Nephropathy

Lesion associated wtih what endocrine disorder?

Calcinosis Cutis Hyperadrenocorticism

Neuroendocrine tumor of the adrenal medulla

Pheochromocytoma

Why do hyperadrenocorticim dogs have a pendulous abdomen?

Hepatomegaly Muscle Atrophy Redistribution of fat

Patient presents with bilaterally symmetric alopecia, polyphagia, PU/PD, potbelly and owner is complaining that he stinks. What endocrine disorder is at the top of your DDx?

Cushing's Disease- Hyperadrenocorticism

Clinical signs of PPID (Equine Cushings)

Hirsuitism PU/PD/PP Hyperhidrosis Insulin Resistance

Adrenocortical hyperplasia can be caused by

Functional Pituitary Tumor

Seen with which endocrine disorder

Secondary Hyperparathyroidism

Iatrogenic hyperadrenocorticism causes what type of lesion?

Adrenocortical atrophy

Pathogenesis of cataracts associated with Diabetes mellitus

1. Excessive glucose is taken up by epithelium of the lens 2. Metabolized to sorbitol by aldose reductase 3. Sorbitol osmotically draws water into the lens 4. Cataract formation

Endocrine function of hyperadrenocorticism?

Hypercorticism

Endocrine function of Pancreatic Islet Cell Carcinoma

Pancreatic Islet Hyperfunction

Endocrine function of Ferret Adrenal Neoplasm

Hyperestrogenism

Lesion associated with what endocrine disease?

PTH Producing Parathyroid Neoplasm associated with Primary Hyperparathyroidism

Benign endocrine neoplasm of ferrets

Insulinoma

Pathogenesis of Beta Cell Amyloidosis due to DM

Long term overstimulation of beta cells → beta cells produce IAPP alonge with insulin → IAPP polymerizes to form amyloid → crowding of islet cells → islet cell atrophy → insulin deficiency and more severe DM

Morphological Diagnosis

Parathyroid Hyperplasia

Endocrine disorder that causes parathyroid hyperplasia, juvenile progressive nephropathy and fibrous osteodystrophy

Secondary Hyperparathyroidism

Pituitary Cysts can result in what endocrine disease?

Hypodrenocorticism - Addison's Disease

Pathogenesis of microangiopathy due to DM

Chronic hyperglycemia → formation of glycosylated proteins → deposition into capillary basement membranes → thickened basement membrane

Histologic appearance of what lesion? Associated with which endocrine disease?

Adrenocortical Adenoma Hyperadrenocorticism - Cushing's Disease

Secondary Hypoadrenocorticism is caused by

Hypopituitarism Exogenous Steroids

Cause of Pseudo-Hyperparathyroidism

PTH-RP producing Neoplasm (Lymphoma, Apocrine Gland Adenocarcinoma of Anal Sac)

Endocrine disorder of ferrets characterized by alopecia, PU/PD, vulvar enlargment, anemia and endometria/prostatic hyperplasia.

Ferret Drenal Neoplasm

Ferret presents with alopeica, PU/PD, vulvar enlargement and anemia. What is at the top of your DDx?

Ferret Adrenal Neoplasm

Morphological Diagnosis

Nodular Thyroid Hyperplasia

In dogs, majority of pituitary adenomas are active and from where?

Pars distalis

Morphological Diagnosis

Lymphocytic Thyroidits

Morphological diagnosis? Seen associated with what endocrine disorder?

Severe renal tubular atrophy, fibrosis, mineralization Juvenile Progressive Nephropathy associated with Secondary Hyperparathyroidism

Pathogenesis of hypothyroidism

TSH stimulatin the thyroid gland → increased TSH occurs when T4 is low due to loss of feedback inhibition

Lesion associated with what endocrine disorder?

Hyperadrenocorticism - Cushing's Disease

Endocrine disease of dogs that causes lymphocytic thyroiditis, myxedema and atherosclerosis. Characterized by increased body weight with no change in appetite, alopecia and scaley skin.

Canine Hypothyroidism

Morphological Diagnosis

Islet Cell Vacuolar Degeneration

Morphological Diagnosis

Pancreatic Islet Cell Carcinoma

Lesion associated with what endocrine disorder?

Cataracts associated with Diabetes Mellitus

Endocrine disease causing tremors, tetany, muscle excitability due to low Ca and high P

Hypoparathryroidsim \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Require a lesion that wipes out all parathyroid glands

Pancreas: Morphological Diagnosis

Acute Pancreatitis

Endocrine disorder characterized by thyroid hyperplasia and follicles lacking colloid.

Goiter

Pathogenesis of Beta Cell Degeneration

Insulin Resistance → long term overstimulation of beta cells → intracellular accumulation of glycogen → vacuolar degeneration of beta cells → insulin deficiency and more severe DM

Lesion associated with what endocrine disorder?

Apocrine Gland Adenocarcinoma of the Anal Sac associated with Pseudo-Hyperparathyroidism

Morphological Diagnosis? Associated with which endocrine disease?

Nodular Adrenocortical Hyperplasia Hyperadrenocorticism - Cushings Disease

Pathogenesis of fibrous osteodystrophy caused by secondary hyperparathyroidism

PTH stimulates increased resorption of bone → chronic PTH stimulates bone marrow stromal cells to differentiate into fibroblasts → high P and low vitamin D → low Ca → inability to properly mineralize growing bone due to low Ca and uremic acidosis

Morphological diagnosis of this histology finding from a cat with diabetes mellitus.

Islet Amyloidosis

Endocrine function of Conn's Syndrome

Hyperaldosteronism

Things that decrease T4

Iodine deficient diet Goiterogenic substances Congenital dyshormonogenic goiter Excess dietery iodide

Significance of Nodular Adrenocortical Hyperplasia

None - typically a senile change

Goiter is an example of what type of endocrine disorder?

Hypothyroidism

Morphological Diagnosis

Thyroid Follicular Carcinoma