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Pathology > Thyroid Pathology > Flashcards

Thyroid Pathology Flashcards

1
Q

Leading cause of hyperthyroidism

A

Grave’s Disease

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2
Q

Pathophys of graves disease

A

development of TSH receptor autoantibodies, stimulates thyroid without negative feedback

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3
Q

What is pretibial myxedma

A

Non-pitting edema

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4
Q

What causes Exopthalmos in Grave’s dz

A

Sympathetic overstimulation of LPS muscless and accumulation of loose CT behind the eyes

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5
Q

What is seen here? Arrows pointing to?

A

Grave’s disease

Arrows pointing to hyperplastic epithelium and scalloped colloid

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6
Q

Major casues of hypothyroidism

A

Thyroiditis

Radiation

Surgical excision

Developmental anomaly (creteinism)

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7
Q

Most common cause of hypothyroidism in North America? Etiology

A

Hashimoto’s Thyroiditis

Autoimmine: T cell defect

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8
Q

Why does Hashimoto’s thyroiditis cause hyperthyroidism early and hypo late?

A

T cell attacking of thyroid stimulates thyroid hormone release, eventually leads to fibrosis

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9
Q

What is seen here?

A

Hashimoto Thyroiditis

Lymphocytic infiltration on left and fibrosis on right

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10
Q

What is seen here?

A

Subacute Lymphocytic Thyroiditis

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11
Q

What is the antibody in Subacute lymphocytic thyroiditis

A

Anti-thyroid peroxidase

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12
Q

What differentiate’s subacute lymphocytic thyroditis from Hashimoto thyroiditis

A

SLT is painless, Hashimoto is painful

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13
Q

What is seen here? Feature?

A

Granulomatous Thyroiditis

Most common cause of thyroid pain

Is self limited and not autoimmune

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14
Q

What is seen here?

A

CMV infected thyroid

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15
Q

4 types of goiters

A
  1. Diffuse/simple
  2. Endemic
  3. Sporadic
  4. Multinodular
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16
Q

When is a goiter endemic?

A

If more than 10% of the population has it, usually in region low in iodine

17
Q

What features of gross pathology will be seen on multinodular goiters

A

Gland will be nodular and focally fibrotic, with hemhorraging

Suggestive of mutiple episodes

18
Q

Most common malignant thyroid nodule? 2nd most common?

A

Papillary carcinoma (about 80%)

Follicular carcinoma (about 10%)

19
Q

What is seen here? Features

A

Follicular adenoma

All produce colloid to some extent

Lacks capsular and vascular invasion

20
Q

What type of pattern do follicular adenomas most often have

A

Follicular, but can also have a solid or trabecular pattern

21
Q

What is seen here?

A

Papillary carcinoma

22
Q

Why are thyroid papillary carcinomas called papillary

A

Nipple like structure with fibrovascular core covered by neoplastic cells

23
Q

What is the arrow pointing to

A

Psammoma bodies (calcifications) seen in papillary thryoid carcinoma

24
Q

What is seen here? What is the arrow pointing to

A

Follicular carcinoma, arrow pointing to capsular invasion

25
What is a medullar carcinoma
Tumor of the parafollicular cells (c cells), which are responsible for producing calcitonin --\> pt's often present with hypocalcemia
26
What is seen here? What mutation can be associated with it
Medullary carcinoma can have germline mutation in RET protoconcogene (MEN IIA)
27
What thyroid carcinoma can produce amyloid materials
Medullary carcinoma
28
Who usually gets anaplastic carcinomas of the thyroid?
Usually older patients with a history of thyroid disease 20-30% ahve concurrent differentiated carcinomas
29
What is theorized to be involved in the development of anaplastic cancer
Developes from other tumors with loss of p53 tumor suppressor gene
30
Genetic alterations in the 3 follicular cell-dervived malignancies are typically what?
Typically in growth factor receptor signalling pathways
31
Most papillary carcinomas have a mutation where?
Gain of function mutation in the genese for RET (or NTRK1) receptor tyrosine kinases
32
What are follicular carcinomas are associated with acquired muations that activate what
RAS, or PI-3K/AKT pathway
33
What occurs in familial medullary thyroid carcinomas?
occurs in MEN-2 with germline RET mutations that lead to constiuative activation of the receptor
34
Factors more likely to be involved in thyroid neoplasm
Solitary In younger males Cold (non-functional)
35
What is seen here?
Thyroglossal duct cyst usually midline, and apparent in childhood or birth Tend to get repeated infections
36
What is seen here? Features?
Substernal goiter Enlarged thyroid that can extend down to the anterior mediastinum
37
What is seen here?
Lateral abberant thyroid in paratracheal musculature
38
What is seen here?
Struma ovali Monodermal teratome of ovary, composed mainly of adult thyroid tissue

Pathology (10 decks)

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