Practical Pathology- Goiter

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    MODULE 15- ENDOCRINE SYSTEM (PATHOLOGY)

    PRACTICAL PATHOLOGY : GOITER

    A)Jars:-

    1.Organ: Thyroid Gland (Page 118-Atlas of Gross Pathology)

    Description:

    The thyroid gland is

    - markedly enlarged and grossly nodular

    - on section, cut surface is nodular and variegated ( variety of colours) in

    appearance showing

    focal areas of brownish translucent colloid

    brownish areas of hemorrhage

    whitish areas of fibrosis and calcificationDiagnosis: Colloid nodular goiter

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    MODULE 15- ENDOCRINE SYSTEM (PATHOLOGY)

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    MODULE 15- ENDOCRINE SYSTEM (PATHOLOGY)

    2. Organ: Thyroid gland (Page 119)

    Description:

    - The thyroid gland is diffusely enlarged with preserved shape

    - On section, cut surface is tan coloured and pancreatic like in

    appearance.

    Diagnosis: Primary thyrotoxicosis (Graves disease)

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    MODULE 15- ENDOCRINE SYSTEM (PATHOLOGY)

    3. Organ : Thyroid gland (Page 120)

    Description :

    - The thyroid gland is enlarged and grossly nodular.

    - On section, cut surface is nodular and variegated (variety of colours) in

    appearance.

    - In one area, a non-encapsulated grayish white mass lesion is detected.

    Diagnosis: Carcinoma of thyroid gland and colloid nodular goiter.

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    MODULE 15- ENDOCRINE SYSTEM (PATHOLOGY)

    B) Slides :-

    1. Colloid nodular goiter (Page 108 -Atlas of Histopathology)

    Section revealed nodular thyroid tissue formed of:

    - Colloid distended follicles of different sizes and shapes some reachinglarge

    - The lining epithelium is low cuboidal to flattened.

    - Traversing fibroconnective tissue bands.

    - Focal stromal fibrosis and areas of fresh and old hemorrhages.

    - Focal stromal calcifications and cholesterol clefts.

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    MODULE 15- ENDOCRINE SYSTEM (PATHOLOGY)

    2. Toxic goiter, Thyroid (page109)

    Section in thyroid gland showing:

    - Numerous follicles of varying sizes and shapes most of which are small.

    - The lining epithelium is hyperplastic and shows occasional papillary

    formation.

    - Some of the follicles are empty and others are filled with pale staining

    colloid showing peripheral scalloping.

    - The stroma in between the follicles shows numerous congested

    vascular spaces and focal lymphocytic infiltration.

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    MODULE 15- ENDOCRINE SYSTEM (PATHOLOGY)

    3. Hashimoto thyroiditis, thyroid (page 110)

    Section in thyroid gland showing:

    - Thyroid follicles mostly of small size.

    - The follicles are lined by epithelial cells showing abundant eosinophiliccytoplasm and vesicular nuclei (Hurthle cells)

    - The surrounding stroma is infiltrated by numerous lymphocytes and

    plasma cells.

    - In areas, lymphoid follicle formation showing reactive germinal centers

    are detected.

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    MODULE 15- ENDOCRINE SYSTEM (PATHOLOGY)

    4. Papillary Carcinoma of thyroid gland (page 113)

    Thyroid tissue infiltrated in one area by tumor tissue formed of:

    - Complex papillary fronds covered by carcinomatous cells showing

    crowded

    overlapping ground glass nuclei showing intranuclear inclusions.

    - Underlying fibrovascular connective tissue cores.

    - In areas, psammoma bodies are detected.