Histopathology 4 - Endocrine disease Flashcards
What are the most common causes of hyper- and hypo-pituitarism?
Hyperpituitarism: functional adenoma
Hypopituitarism: nonsecretory adenomas/ ischaemic necrosis/ surgery
What are the 3 symptoms of local mass effect of pituitary tumours?
Bitemporal hemianopia
Elevated ICP
Obstructive hydrocephalus
Recall 4 differentials for primary hyperthyroidism
- Grave’s
- Hyperfunctioning multinodular goitre
- Hyperfunctioning adenoma
- Thyroiditis
What is the cause of secondary hyperthyroidism?
TSH-secreting pituitary adenoma (rare)
How can struma ovarii cause thyroid disease?
Ovarian teratomas can secrete ectopic thyroxine
What autoimmune condition can cause hypothyroidism?
Hashimoto’s
Differentiate the type of auto-antibodies involved in Grave’s vs Hashimoto’s
Grave’s: anti-TSH receptor
Hashimoto’s: anti-TPO and anti-TG (thyroglobulin)
What is the histological appearance of a Hashimoto’s thyroid?
Lymphocyte aggregates and transformed follicular cells
What are the main symptoms of Hashimoto’s?
Clinically hypothyroid
Painless goitre
Recall 4 differentials for the cause of hypothyroidism
- Postablative
- Iodine deficiency
- Congenital biosynthetic defect
- Autoimmune (Hashimoto’s)
What is a thyroid adenoma?
Benign neoplasm of follicular thyroid epithelium
How are thyroid adenomas diagnosed?
FNA and cytology
What is the most common type of thyroid adenoma?
Papillary
What are the key histological features of papillary thyroid cancer?
Optically clear nuclei
Psammoma bodies
Orphan Anne Nuclei
Which type of thyroid adenocarcinoma is associated with Multiple Endocrine Neoplasia?
Medullary
Which type of thyroid adenocarcinoma is most aggressive?
Aplastic
What are the 4 subtypes of thyroid adenocarcinoma?
Follicular
Papillary (most common)
Medullary (associated with MEN, check CEA and calcitonin)
Anaplastic (most malignant)
What is the most common cause of primary hyperparathyroidism?
Solitary adenoma
What is the most common symptom of hyperparathyroidism?
Clinically silent hypercalcaemia (so not really a symptom)
What is secondary hyperparathyroidism almost always caused by?
Renal failure
Recall 3 possible causes of hypoparathyroidism
Surgical ablation
Congenital absence
Auto-immune
Recall 4 possible symptoms of hypoparathyroidism
Those of hypocalcaemia: Muscle spasms/ tetany Cardiac arrhythmias Fits Cataracts
Recall the synthetic function of each zone of the adrenals
Medulla: Noradrenaline and adrenaline
Reticularis: androgens
Fasciculata: glucocorticoids
Glomerulosa: aldosterone
What is Waterhouse-Friedrichson syndrome?
Adrenal insufficiency with sepsis and DIC
