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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
Q

What is a medullar carcinoma

A

Tumor of the parafollicular cells (c cells), which are responsible for producing calcitonin –> pt’s often present with hypocalcemia

26
Q

What is seen here? What mutation can be associated with it

A

Medullary carcinoma

can have germline mutation in RET protoconcogene (MEN IIA)

27
Q

What thyroid carcinoma can produce amyloid materials

A

Medullary carcinoma

28
Q

Who usually gets anaplastic carcinomas of the thyroid?

A

Usually older patients with a history of thyroid disease

20-30% ahve concurrent differentiated carcinomas

29
Q

What is theorized to be involved in the development of anaplastic cancer

A

Developes from other tumors with loss of p53 tumor suppressor gene

30
Q

Genetic alterations in the 3 follicular cell-dervived malignancies are typically what?

A

Typically in growth factor receptor signalling pathways

31
Q

Most papillary carcinomas have a mutation where?

A

Gain of function mutation in the genese for RET (or NTRK1) receptor tyrosine kinases

32
Q

What are follicular carcinomas are associated with acquired muations that activate what

A

RAS, or PI-3K/AKT pathway

33
Q

What occurs in familial medullary thyroid carcinomas?

A

occurs in MEN-2 with germline RET mutations that lead to constiuative activation of the receptor

34
Q

Factors more likely to be involved in thyroid neoplasm

A

Solitary

In younger males

Cold (non-functional)

35
Q

What is seen here?

A

Thyroglossal duct cyst

usually midline, and apparent in childhood or birth

Tend to get repeated infections

36
Q

What is seen here? Features?

A

Substernal goiter

Enlarged thyroid that can extend down to the anterior mediastinum

37
Q

What is seen here?

A

Lateral abberant thyroid in paratracheal musculature

38
Q

What is seen here?

A

Struma ovali
Monodermal teratome of ovary, composed mainly of adult thyroid tissue

Pathology (10 decks)

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