Thyroid Pathology Flashcards
What protein mix does the colloid contain?
glycoprotein mix
What kind of cells are C cells?
neuroendocrine cells
How does an inactive thyroid gland look under microscope?
low cuboidal cells
follicle filled with colloid
How does an active thyroid gland look under microscope?
tall cuboidal to columnar cells
scalloping of colloid
What are the signs of hypometabolic state?
cold intolerance cold thickened skin alopecia weight gain fatigue SNS underactivity
What are the signs of hypermetabolic state?
heat intolerance warm flushed skin fatigue weight loss osteoporosis SNS overactivity
What is the risk of taking thyroxin as a weight loss pill?
there is possible osteoporosis
What causes simple goitre?
impaired synthesis of thyroid hormone, and feedback induces spike of TSH
What’s the most common cause of simple goitre?
dietary iodine deficiency
What are the main features of simple goitre on histological slides?
cells are hyperplastic, follicles lined by crowded cells, follicle sizes are not uniform,
follicles have low cuboidal epithelium and abundant colloid, which can haemorrhage and grow larger
Can simple goitre be nodular?
yes, overtime with cycles of hyperplasia
What does simple goitre look like under radioactive iodine?
multinodular
What’s the treatment of simple goitre?
surgery
What does Hashimoto thyroid look under the microscope?
lymphocyte infiltration with germinal centres
scar tissue + fibrosis (increased interstitial connective tissue)
cells with large eosionophilic cytoplasms
Does Hashimoto thyroid always atrophy?
No, it initially goes through a stage of hypertrophy
What does the cut surface of Hashimoto thyroid look?
firm, tan-yellow, pale if fibrotic, somewhat nodular
How does the thyroid tissue get damaged in Hashimoto?
tolerance breakdown leading to immunity against self
damage caused by CD8, cytokine, antibody-mediated damage, TSH-blocking antibody reducing further thyroid function
T/F Hashimoto has a rapid onset
false, it has a gradual onset
What are Hurthle cells?
thyroid cells with abundant, eosinophilic, granular cytoplasm
What is the management of hypothyroidism?
hormone replacement
What are the three clinical signs of Graves?
diffuse enlargement of thyroid
infiltrative ophthalmopathy with exophthalmos
localised infiltrative dermopathy
which antibody can be found in the FBE of a Hashimoto patient?
TPO antibody
what does the histology for Graves look like?
elongated cells
hyperplasia, crowded space, not much colloid
What are the differences between Graves and simple goitre under the microscope?
Graves is diffused, and there is less colloid
Which antibody can be found in Graves?
TSI
TGSI
TBII
what is the function of TBII
stimulate or inhibit TSH receptor, therefore there can be (but rare) hypothyroidism in Graves
What is the pathogenesis of opthalmpathy in Graves?
the fibroblasts at the orbital area express TSH-like antigens to trigger autoimmunity leading to inflammation, fibrosis and adipocyte transformation
T/F Hashimoto is a type II, antibody mediated disease
False, it is a type IV, delayed type hypersensitivity
which iodine is used to ablate the thyroid?
Iodine 131`
