Department of pathology Li shuhua. nontoxic goiter Toxic goiter adenoma adenocarcinoma

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Text of Department of pathology Li shuhua. nontoxic goiter Toxic goiter adenoma adenocarcinoma

  • Department of pathology Li shuhua

  • nontoxic goiter Toxic goiteradenomaadenocarcinoma

  • Diffuse nontoxic goiterPathogenesis:Dietary iodine deficiency endemicNot apparent sporadicImpaired synthesis of thyroid hormoneRise TSH level in serumHypertrophy and hyperplasia of thyroid follicular cellsGross enlargement of the thyroid gland

  • morphologyDiffuse hyperplastic goiterDiffuse colloid goiterNodular goiter

  • Diffuse hyperplastic goiterDiffusesymmetric enlargement of the gland;
  • Diffuse colloid goiterCut surface: brown, glassy, translucent; 200-300gColloid is abundant in the follicles; follicular epithelium are flattened or cuboidal or hyperplasia.

  • Nodular goiter macroscopically:Multilobulated, asymmetrically enlarged glandsCut surface: irregular nodules containing variable amount of brown,gelatinous colloid;

  • microscopicallyRegressive changes: fibrosis, hemorrhage, calcification, cysticColloid-rich follicles lined by flattened epithelium and areas of follicular epithelial hypertrophy and hyperplasia;

  • Diffuse toxic goiter(graves disease)Pathogenesis: autoimmune disorder

  • Morphology:

    1.diffusely enlarged, gland is smooth and soft,capsule is intact2.microscopically: follicular epithelial cells are tall,columnar ,crowed, formation of small papillae; colloid is pale with scalloped margins.3.vessel and lymphoid aggregates

  • Clinical features

    diffuse hyperplasia of the thyroid, ophthalmopathy, dermopathy

  • adenomas1.solitary, spherical, encapsulated lesion2.cut surface:gray white to red brown; regressive change3.microscopically :form relatively uniform, normal-appearing follicles that contain colloid.4. Well-defined, intact capsule5.histologic subtypes

  • carcinoma1.papillary carcinoma2.follicular carcinoma3.medullary carcinoma4.anaplastic carcinoma