Thyroid and parathyroid pathology Flashcards

1
Q

where are chief cells found

A

parathyroid glands

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2
Q

what do chief cells produce

A

parathyroid hormone- pTH

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3
Q

role of PTH

A

regulates calcium levels in blood and bone

enhances calcium resorption in kidneys and release of calcium from bones

increases production of vitamin D to enhance intestinal calcium absoption

deceases calcium loss in urine, increases phosphate excretion

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4
Q

what receptors do chief cells contain

A

calcium sensing receptors

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5
Q

parathyroid adenoma

A

benign tumour

most common cause of hyperparathyroidism

Conditions such as Multiple Endocrine Neoplasia (MEN) types 1 and 2 or familial isolated hyperparathyroidism increase the risk.

single parathyroid gland

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6
Q

hyperparathyroidism

A

excessive parathyroid hormone (PTH) leading to elevated calcium levels in the blood

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7
Q

parathyroid hyperplasia

A

A non-tumorous condition where all four parathyroid glands are enlarged and hyperfunctioning

It can be sporadic or associated with genetic syndromes like multiple endocrine neoplasia (MEN)

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8
Q

parathyroid carcinom a

A

extremely rare cancer of parathyroid glands

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9
Q

diagnostic criteria

A

Parathyroid tumour showing at least one of the following:
Angioinvasion
Lymphatic invasion
Perineural invasion
Invasion of adjacent structures/organs
Regional/distant metastasis

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10
Q

c cells

A

parafollicular cells
specialised cells in thyroid gland
play essential role in calcium homeostasis
derived from neural crest

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11
Q

staining of c cells

A

pale staining

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12
Q

where are c cells

A

between follicular cells or within connective tissue of the gland

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13
Q

what signals the hypothalamus and pituitary to stop stimulating

A

t3 and t4 when adequate amount

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14
Q

thyroid physiology

A

hypothalamus produces TRH which stimulates pituitary

pituitary releases TSH which stimulates thyroid gland

thyroid roduces t3 and t4

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15
Q

non neoplastic conditions

A

Multinodular goitre

Hashimotos thyroiditis

Graves disease

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16
Q

multinodular goitre

A

thyroid gland becomes enlarged and develops many nodules
commonly due to iodine deficiency

17
Q

hashimoto thyroiditis

A

autoimmune process
female predominance
body attacks thyroid gland by producing antobodies to attack

18
Q

which anitbodies are present in hashimotos

A

anti thyroid peroxidase - anti TPO

Anti thyroglobulin- anti- Tg

19
Q

benign neoplasms

A

follicular adenoma
oncocytic adenoma

20
Q

benign ish

A

NIFT-P
Thyroid Tumour of Uncertain Malignant Potential
Hyalising Trabecular Tumour

21
Q

malignant

A

Papillary carcinoma
Medullary carcinoma
Follicular carcinoma
Oncocytic carcinoma
High grade follicular cell derived non-anaplastic thyroid carcinoma
Poorly differentiated thyroid carcinoma
Differentiated high grade thyroid carcinoma

22
Q

follicular adenoma v carcinoma

A

thyroid nodule arising from follicular cells
usually slow growing
lacks capsular/ vascular invasion

if carcinoma then is invasive via vascular / capsular

23
Q

oncocytic adenoma

A

swollen and pink cells
encapsulated non invasive
characterised by oncocytes

24
Q

oncocytes

A

cells with an abnormal increase in number of mitochondria which gives them a distincitve appearance under microscope

25
Q

most common thyroid malignancy

A

papillary thyroid carcinoma

26
Q

medullary carcinoma

A

c cell derived neoplasm
assoc with men2a or men2b
often assoc with increased calcitonin / carcinoembryonic antigen

27
Q

anaplastic carcinoma

A

undiffernetiated thyroid cancer
aggressive progression
poor prognosis
fatal outcome
thyroid IHC marksers usually lost

28
Q

thyroid IHC markers

A

thyroglobulin
thyroid transcription factor 1
PAX8

29
Q
A