XX - The Endocrine System Flashcards
A benign, well-circumscribed, soft lesion of the pituitary gland that may compress the optic chiasm and adjacent structures. Composed of relatively uniform, polygonal cells arrayed in sheets, cords, or papillae.
Pituitary adenoma (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 754
Most common type of hyperfunctioning pituitary adenoma.
Prolactinomas (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 754
Microscopically, these are composed of densely or sparsely granulated cells, and immunohistochemical stains demonstrate growth hormone within the cytoplasm of the neoplastic cells.
Growth Hormone-Producing Adenomas (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 754
A condition characterized by excessive urination (polyuria) caused by an inability of the kidney to properly resorb water from the urine.
Diabetes insipidus(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 757
Enzyme deficient in central Diabetes insipidus.
Anti-diuretic hormone(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 757
Disease caused by excessive levels of ADH, leading to resorption of excess water, with resultant hyponatremia.
syndrome of inappropriate ADH secretion (SIADH)(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 757
The most common cause of hypothyroidism in areas of the world where iodine levels are sufficient. Presents as painless enlargement of the gland, associated with hypothyroidism.
Hashimoto thyroiditis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 757
The thyroid is diffusely and symmetrically enlarged, with intact capsule. Microscopically, reveals a mononuclear inflammatory infiltrate and the presence of Hurthle or oxyphil cells, which are cells with eosinophilic, granular cytoplasm.
Chronic Lymphocytic (Hashimoto) Thyroiditis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 761
A rare disorder characterized by extensive fibrosis involving the thyroid and contiguous neck structures. Idiopathic in nature.
Riedel thyroiditis(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 762
Believed to be caused by a viral infection or a postviral inflammatory process, this lesion of the thyroid gland is characterized by unilateral or bilateral enlargement of the thyroid, with disruption of thyroid follicles. Extravasation of colloid leads to a granulomatous reaction. Healing occurs by resolution of inflammation and fibrosis.
Subacute Granulomatous (de Quervain) Thyroiditis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 762
Also known as “silent” or “painless” thyroiditis n a subset of patients the onset of disease follows pregnancy. Unlike Hashimoto thyroiditis, follicular atrophy or Hurthle cell metaplasia are not commonly seen.
Postpartum thyroiditis/ Subacute Lymphocytic Thyroiditis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 762
Thyroid gland is diffusely enlarged due to hyperplasia and hypertrophy of the thyroid follicular cells. The follicular epithelial cells are tall, columnar, and more crowded than usual. These cells actively resorb the colloid in the centers of the follicles, resulting in the “scalloped” appearance of the edges of the colloid.
Graves Disease(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 764
Goiter which occurs in areas where the soil, water and food supply contain little iodine.
Endemic goiter(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 765
Diffuse, symmetric enlargement of the gland due to TSH-induced hypertrophy and hyperplasia of thyroid follicular cells.
Diffuse goiter(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 765
Goiter characterized by enlarged, colloid-rich gland. On cut surface, the thyroid is usually brown, glassy and translucent.
Colloid goiter(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 765
Irregular enlargement of the thyroid as a result of recurrent episodes of hyperplasia and involution.
Multinodular goiter(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 765
Probability of being benign or malignant.A solitary nodule seen in a 20-yr old male.
Malignant(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 766
Probability of being benign or malignant.Multiple, hot nodules.
Benign(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 766
Probability of being benign or malignant.A solitary, cold nodule.
Malignant(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 766
A solitary, spherical lesion that compresses the adjacent non-neoplastic thyroid. Neoplastic cells are demarcated from the adjacent parenchyma by a well-defined, intact capsule, which is a hallmark of this tumor.
Thyroid adenoma (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 766
Most common carcinoma of the thyroid.
Papillary carcinoma (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 767
Thyroid carcinoma which may occur at any age and is associated with previous exposure to ionizing radiation. The nuclei of cells contain very finely dispersed chromatin, which imparts an optically clear appearance, giving rise to the designation “ground-glass” or “Orphan Annie eye” nuclei.
Papillary carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 767
The second most common form of thyroid cancer. Usually present at an older age a peak incidence in the middle adult years. Microscopically, these are composed of fairly uniform cells forming small follicles, reminiscent of normal thyroid.
Follicular Carcinoma (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 769
Neuroendocrine neoplasms derived from the parafollicular cells, or C cells, of the thyroid, which secrete calcitonin. Associated with MEN 2A and 2B. May be solitary or multicentric, composed of polygonal to spindle-shaped cells, which may form nests, trabeculae, and follicles, contains amyloid.
Medullary carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 770
Carcinoma of the thyroid usually seen in the elderly. Associated with high mortality rate. These present as bulky masses that typically grow rapidly beyond the thyroid capsule into adjacent neck structures.
Anaplastic carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 771
A solitary lesion of the parathyroid gland which are composed predominantly of chief cells almost invariably confined to a single gland. A rim of compressed, non-neoplastic parathyroid tissue, generally separated by a fibrous capsule, is often visible at the edge of the adenoma.
Parathyroid adenoma(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 773
These tumors of the parathyroid glands are usually firm or hard tumors, adhering to the surrounding tissue as a result of fibrosis or infiltrative growth. May weigh >5 grams. The cytologic features and mitotic activity are variable.
Parathyroid carcinomas (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 773
Inadvertent removal of parathyroids during thyroidectomy.
Surgical ablation(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 775
An autoimmune disease characterized by progressive destruction of islet beta cells, leading to absolute insulin deficiency.
Type 1 diabetes mellitus(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 781
Caused by a combination of peripheral resistance to insulin action and an inadequate compensatory response of insulin secretion by the pancreatic beta cells.
Type 2 diabetes mellitus(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 781
Vascular lesion associated with hypertension, which is more prevalent in diabetics.
Hyaline arteriolosclerosis(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 781
A diffuse increase in mesangial matrix along with mesangial cell proliferation and is always associated with basement membrane thickening of the glomerulus. Seen in patients with diabetes mellitus.
Diffuse mesangial sclerosis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 783
A glomerular lesion made distinctive by ball-like deposits of a laminated matrix situated in the periphery of the glomerulus .
Nodular glomerulosclerosis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 783
The ball-like deposit seen in nodular glomerulosclerosis.
Kimmelstiel-Wilson lesion(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 783
A special pattern of acute pyelonephritis seen more often in diabetics.
Necrotizing papillitis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 784
Most common pancreatic endocrine neoplasms.
beta-cell tumors (insulinomas) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 788
These benign tumors look remarkably like giant islets, with preservation of the regular cords of monotonous cells and their orientation to the vasculature.
Insulinomas (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 788
What syndrome is described by the association of pancreatic islet cell lesions with hypersecretion of gastric acid and severe peptic ulceration?
Zollinger-Ellison syndrome(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 788
Tumors associated with increased serum glucagon and a syndrome consisting of mild diabetes mellitus, a characteristic skin rash (necrolytic migratory erythema), and anemia.
alpha-Cell tumors (glucagonomas) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 789
Most common cause of Cushing syndrome.
Administration of exogenous glucocorticoids(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 789
Primary hypothalamic-pituitary disease associated with oversecretion of ACTH. The adrenal glands characterized by variable degrees of bilateral nodular cortical hyperplasia.
Cushing disease(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 789
In this condition, the normal granular, basophilic cytoplasm of the ACTH-producing cells in the anterior pituitary is replaced by homogeneous, lightly basophilic material. This results from high levels of endogenous or exogenous glucocorticoids.
Crooke hyaline change(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 790
Lung cancer associated with a paraneoplastic syndrome leading to excessive production of ACTH.
Small-cell lung cancer(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 792
Caused either by an aldosterone-producing adrenocortical neoplasm, usually an adenoma, or by primary adrenocortical hyperplasia, resulting in suppression of the renin-angiotensin system and decreased plasma renin activity.
Primary hyperaldosteronism/ Conn syndrome(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 792
A characteristic feature of aldesterone-producing adenomas which is the presence of eosinophilic, laminated cytoplasmic inclusions. These are typically found after treatment with the anti-hypertensive drug which is the DOC for primary hyperaldosteronism.
Spironolactone bodies(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 792
The adrenals are hyperplastic bilaterally, sometimes expanding to 10 to 15 times their normal weights,due to sustained elevation in ACTH. The adrenal cortex is thickened and nodular, and on cut section, the widened cortex appears brown as a result of depletion of all lipid
Congenital adrenal hyperplasia(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 793
Acute adrenal insufficiency caused by severe bilateral adrenal hemorrhage in an infant with overwhelming sepsis. The adrenals are grossly hemorrhagic and shrunken; microscopically, little residual cortical architecture is discernible
Waterhouse-Friderichsen syndrome(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 794
An uncommon disorder resulting from progressive destruction of the adrenal cortex. May be due to autoimmune adrenalitis, tuberculosis, AIDS, or metastatic cancers.
Addison disease/ chronic adrenocortical insufficiency(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 794
The adrenals are reduced to small, flattened structures that usually retain their yellow color because of a small amount of residual lipid. Histologically, there is atrophy of cortical cells with loss of cytoplasmic lipid, particularly in the zonae fasciculata and reticularis, due to decreased ACTH stimulation.
Secondary hypoadrenalism (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 795
Characterized by irregularly shrunken glands, which may be exceedingly difficult to identify within the suprarenal adipose tissue. Histologically, the cortex contains only scattered residual cortical cells in a collapsed network of connective tissue.
Primary autoimmune adrenalitis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 795
Neoplasms composed of chromaffin cells which synthesize and release catecholamines and other peptide hormones. Composed of polygonal to spindle-shaped chromaffin cells compartmentalized intonests, or “Zellballen,” by a rich vascular network.
Pheochromocytomas(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 797
Most common extra-cranial solid tumor of childhood. Occur most commonly during the first 5 years of life and may arise during infancy.
Neuroblastoma (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 798
Components of MEN1?
Parathyroid: Primary hyperparathyroidismPancreas: ZES, insulinoma, etc.Pituitary: prolactin-secreting macroadenoma, somatotrophin-secreting tumors(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 798
Components of MEN2A?
Thyroid: Medullary carcinomaAdrenal medulla: pheochromocytomasParathyroid: parathyroid gland hyperplasia (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 799
Components of MEN2B?
Thyroid: Medullary carcinomaAdrenal medulla: pheochromocytomaExtraendocrine manifestations: ganglioneuromas of mucosal sites (gastrointestinal tract, lips, tongue) and marfanoid habitus (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 799
All individuals carrying germ-line RET mutations are advised to undergo prophylactic thyroidectomy to prevent the development of what type of carcinoma?
Medullary Carcinoma (TOPNOTCH)
What is the most common site of gastrinomas in individuals with MEN-1?
Duodenum (TOPNOTCH)
What is the most frequent anterior pituitary tumor encountered in individuals with MEN-1?
Prolactinoma (TOPNOTCH)
Morphology: demonstrates characteristic nests of cells (zellballen) with abundant cytoplasm
Pheochromocytomas (TOPNOTCH)
Morphology: the adrenals are grossly hemorrhagic and shrunken with little residual cortical architecture discernable
Waterhouse Friederichsen Syndrome (TOPNOTCH)
What is the most common cause of primary adrenal insufficiency in developed countries?
Autoimmune adrenalitis (TOPNOTCH)
Spirinolactone bodies are seen in what tumor?
Aldosterone producing adenomas (TOPNOTCH)
Crook hyaline change is seen in?
Cushing syndrome (TOPNOTCH)
Watery Diarrhea, hypokalemia, achlorhydria or WDHA syndrome is seen in?
VIPoma (TOPNOTCH)
Syndrome of mild DM, characteristic rash (necrolytic migratory erythema), and anemia is seen in what tumor?
Glucagonomas or alpha cell tumors (TOPNOTCH)
Syndrome of DM, cholelithiasis, steatorrhea, and hypochlorhydria is seen in what tumor?
Somatostatinoma or delta cell tumor (TOPNOTCH)