Pathology of endocrine system clinical Flashcards
Causes of primary hyperparathyroidism (3)
Adenoma - most common
Hyperplasia
Carcinoma - RARE
Primary hyperparathyroidism often presents as
asymptomatic hypercalcaemia
Cause of secondary hyperparathyroidism
Physiological response to decreased Ca2+ due to renal failure
3 major histological cell types of the anterior pituitary
Acidophils (pink)
Basophils (purple)
Chromophobes
What do acidophils of the AP secrete (2)
GH
Prolactin
What do basophils of the AP secrete (4)
ACTH, TSH, FSH, LH
Non-functioning pituitary adenoma (i.e. non-secreting) may present as what
mass lesion –> mass pressure effect
elevated ICP - e.g. papilloedema
bitemporal hemianopia
hypopituitarism - from compression damage
Causes of hypopituitarism (4)
Compression by other tumours, e.g. craniopharyngioma
Trauma
Infection (rare) - TB, sarcoidosis
Post partum ischaemic necrosis - Sheehan’s syndrome
Histological features of adrenal adenomas (4)
Cells similar to those of normal adrenal cortex
Small nuclei
Some pleomorphism of cells
Lots of secretory granules in cytoplasm (granular cytoplasm)
Carcinomas of the adrenal cortex are usually caused by what
Metastases from another tumour - lung, breast
Rare to be a primary adrenal cortical tumour
Histological features of a phaeochromocytoma (2)
Nests of chromaffin or chief cells
Granular cytoplasm - i.e. lots of secretory granules
What is multiple endocrine neoplasia (MEN)
Inherited disorders in which several endocrine glands benign or malignant tumours due to underlying genetic mutation
Multiple endocrine neoplasia (MEN) type 1 (used to be called wermer syndrome) is caused by a mutation of what gene
coincidentally is due to a mutation of the MEN1 gene - a gene that codes for a protein called menin which acts as a tumour suppressor
so defect in this gene –> loss of down-regulation –> up-regulation
Multiple endocrine neoplasia (MEN) type 1 is associated with (usually benign) tumours of what 3 endocrine glands
Parathyroid
Pancreas
Pituitary - often prolactinoma
Multiple endocrine neoplasia (MEN) type 2 is caused by a mutation of what gene
RET (a proto-oncogene)
