Thyroid pathology Flashcards
Symptoms of hypothyroidism
1) fatigue, weakness 2) dry skin 3) feeling cold 4) hair loss 5) memory 6) constipation 7) weight gain with poor appetite 8) menorrhagia
What artery feeds the thyroid gland?
Superior thyroid artery which is a branch off the common carotid arteries
Signs of hypothyroidism
1) dry coarse skin with puffy face, hands, and feet 2) diffuse alopecia 3) bradycardia 4) peripheral edema 5) carpal tunnel syndrome with delayed tendon reflex relaxation 6) serous cavity effusions
Symptoms of hyperthyroidism
1) fatigue and weakness with hyperactivity, irritability, and dysphoria 2) heat intolerance and sweating 3) palpitations 4) weight loss with increased appetite 5) diarrhea 6) oligomenorhea, loss of libido
Signs of hyperthyroidism
1) tachycardia, atrial fibrillation (in the elderly) 2) tremor and goiter 3) warm, moist skin 4) muscle weakness with proximal myopathy 5) lid retraction
Causes of hypothyroidism
1) radioactive I codeine ablation aka RAI 2) thyroid agenesis/surgery 3) thyroiditis 4) drugs 5) low iodine intake 6) defects of origanification of iodine (congenital)
Causes of hyperthyroidism
1) Graves’ disease 2) adenoma, TSH producing adenoma 3) RAI 4) thyroiditis 5) high iodine intake 6) binding protein abnormalities 7) resistance to thyroid hormone
What’s the half life of t4 and t3
T4 = 6.2 days T3 = 1 day
Pathophysiology of Grave’s Disease
- Immune ediated production of TSH Receptor antibodies
- Binding of antibodes to Rs cause thyroid stimulation w/o negative feedback
- binding of the same antibodies to other tissue sites cause production og glycosaminoglycans –> exophthalmos, myxedema.
Histopathology of Graves Disease
Thyroid epithelium = hyperplastic
Scalloped colloids.
What is the most common cause of hypothyroidism in North America where dietary iodine is sufficient?
hashimoto thyroiditis
Is hashimoto thyroiditis more common in males or females?
more common in women–tought that there is an autoimmune defect
What does this patient have? Describe what you see
Intense lymphocytic infiltration with tissue destruction. This is early hashimoto’s disease. Early in the disease there is HYPERthyroidism because the thyroid gets destroyed and thyroid enzymes get leaked out so you have increased T3/T4/TSH
What does this patient have? Describe what you see.
hashimoto thyroiditis with lymphocytic iniltration and tissue destruction (middle of the way to destruction). First get hyperthyroidism then hypothyroidism.
What does this person have? Describe what you see.
This is late hashimoto’s thyroiditis. You can see a lot of fibrosis and lymphocytic infiltration. In late hash disease, you get HYPOthyroidism because you run out of thyroid enzymes and you have DECREASED T4 and increased TSH
What does this patient have? Describe what you see
There is lymphocytic inflammation of
Etiology of subacute lymphocytic thyroiditis?
Cause of subacute lymphocytic thyroiditis
What does this patient have? Describe what you see.
Mixed inflammatory reaction with prominent giant cell formation. This patient has granulomatosis DeQuervain’s thyroiditis.
What does this person have? Describe what you see.
multinodular goiter; gland is nodular with focally fibrotic and hemorrahging which suggests multiple episodes of proliferation,
What does this patient have? Describe what you see.
Diffuse/multinodular goiter. Colloid nodule with internal regression and cyst formation. There is a band of fibrosis which separates the
what is this? describe the features of this disease
- Follicular adenoma.
- well circumscribed and encapsulated with lack of capsular and vascular invasion wich must be confirmed on microscopic evaliation since it could also be follicular carcinoma.
- Shown in the picture here are follicular adenomas that produce colloid to some extent
What is this?
Follicular adenoma with SOLID pattern. Can also have trabecular pattern as shown in this picture. Whatever the pattern, the neoplastic cells are different from surrounding normal tissue.
Describe what you see. What does this patient have?
Nipple like structures (papillae) with fibrovascular core covered by neoplastic cells.
This patient has papillary carcinoma.
Describe what you see. What does this patient have?
Not well circumscribed
What is this? What disease is this seen in?
This is a psammoma body which is a round collection of calcium. Seen in papillary carcinoma.
what is this showing? what disease is this seen in?
This is showing capsular invasion as seen with follicular carcinoma. another histopath picture shown here.
What is this showing? what disease is this seen in
vascular invasion seen in papillary carcinoma
