Thyroid pathology Flashcards
Name the 4 B’s of T4 function
Brain development
Bone growth
Beta adrenergic effects
BMR increase
Patients lab results: high TSH, high T4. What is the pathology?
secondary/tertiary hyperthyroidism: pituitary or hypothalamus pathology
What are some signs and symptoms of hyperthyroidism?
weight loss, heat intolerance, cardiac arrhythmia, neuro-muscular problems: tremors, warm moist skin, diarrhea, lid lag, thyroid storm
What are the most common causes of hyperthyroidism?
Graves disease, multi-nodular goiter, thyroid adenoma
What are the symptoms of hypothyroidism?
weight gain, fatigue, cold intolerance, bradycardia, myxedema –> hoarse voice, myxedema coma
What are the two broad categories causing hypothyroidism?
congenital or acquired
Describe thyroiditis
inflammation of thyroid gland
F>M
acute/painful or silent/chronic
How do you diagnose thyroiditis?
decreased I (123) uptake
What would you see microscopically in a case of Hashimoto’s thyroiditis?
Hurkle cells
Describe the pathophysiology of Hashimoto’s thyroiditis?
T cell don’t recognize own thyroid antigens as self, attack thyroid, T cells stimulate B cells to produce antibodies to TSH receptors, thyroglobulin, and peroxidase
What is myxedema?
leakage of colloid out of thyroid into peripheral tissues, skin does not yield under pressure
Describe DeQuervain’s thyroiditis
large sore thyroid after URI due to increase in CD8 cells causes leakage of follicle cells and foreign body giant cell reaction, not serious
Why is Bullseye the horse from Toy Story the symbol for Silent Thryoiditis?
silent and does not cause trouble
painless, slightly large thyroid in post-partum/middle aged women
What is the biggest risk with Reidel’s thyroiditis?
rock hard woody-like mass can cause tracheal compression
How would you diagnose Grave’s disease?
decreased TSH, increased T4 (primary hyperthyroidism), radioactive scan = diffuse increased uptake, clinical triad
What is the clinical triad of Grave’s syndrome?
hyperthyroidism, opthalmopathy, dermopathy
What micro path findings are indicative of Grave’s disease?
papillae and scalloped colloid
How do you treat Grave’s disease?
treat sx: beta blockers or surgery
treat thyroid over-synthesis: drugs, I (131) ablation, surgery
What are three main causes of goiters?
inflammatory thyroiditis
non-inflammatory T4 synthesis defect
Iodide def.
You would see signs of cyclic involution and hyperplasia in what thyroid pathology?
multi-nodular goiter
What drugs are used to treat/prevent Goiters?
Levothyroxine (T4 analog)
What are the three possible pathological findings for fine needle aspirate bx of thyroid?
cancer- remove
just follicles- remove
thyroiditis- treat
What is the most common benign neoplasm of the thyroid?
thyroid adenoma
What are some possible genetic mutations in thyroid adenoma?
G protein mutation
gain of function mutation
You see a salt-and-pepper nucleus on a cytology thyroid sample, what is it?
medullary thyroid carcinoma
What differentiates medullary thyroid carcinoma from other cancers of the thyroid?
it is a cancer of the C cells
endocrine cancer as opposed to epithelial in origin
What is the “worst” malignant neoplasm of the thyroid?
anaplastic thyroid carcinoma
< 10% 5 yr, usu mets. @ dx.
Name 3 things about papillary thyroid carcinoma?
most common malignancy of the thyroid
Orphan Annie nuclei
psammoma bodies (Sand[y])
