Department of pathology Li shuhua

1
endocrine system
Department of pathology Li shuhua
2
nontoxic goiter
Toxic goiter
adenoma
adenocarcinoma
3
(No Transcript)
4
Diffuse nontoxic goiter
Pathogenesis
Dietary iodine deficiency endemic Not
apparent sporadic
Impaired synthesis of thyroid hormone
Hypertrophy and hyperplasia of thyroid follicular
cells
Rise TSH level in serum
Gross enlargement of the thyroid gland
5
morphology
Diffuse hyperplastic goiter
Diffuse colloid goiter
Nodular goiter
6
Diffuse hyperplastic goiter

• Diffuse,symmetric enlargement of the gland
  lt150g
• 2. follicle are lined by crowded columnar
  cells, which may pile up and form projections.
  There is only little colloid in the follice

7
???????
8
Diffuse colloid goiter

1. Cut surface brown, glassy, translucent
   200-300g
2. Colloid is abundant in the follicles
3. follicular epithelium are flattened or cuboidal
   or hyperplasia.

9
??????????
10
Nodular goiter

• macroscopically
• Multilobulated, asymmetrically enlarged glands
• Cut surface irregular nodules containing
  variable amount of brown,gelatinous colloid

11
microscopically

1. Regressive changes fibrosis, hemorrhage,
   calcification, cystic
2. Colloid-rich follicles lined by flattened
   epithelium and areas of follicular epithelial
   hypertrophy and hyperplasia

12
??????????
13
Diffuse toxic goiter
(graves disease)
Pathogenesis autoimmune disorder
14
Morphology 1.diffusely enlarged, gland is
smooth and soft,capsule is intact 2.microscopicall
y follicular epithelial cells are
tall,columnar ,crowed, formation of small
papillae colloid is pale with scalloped
margins. 3.vessel and lymphoid aggregates
15
???????
16
Clinical features diffuse hyperplasia of the
thyroid, ophthalmopathy, dermopathy
17
?????
18
??
19
adenomas
1.solitary, spherical, encapsulated lesion 2.cut
surfacegray white to red brown regressive
change 3.microscopically form relatively
uniform, normal-appearing follicles that contain
colloid. 4. Well-defined, intact
capsule 5.histologic subtypes
20
?????
21
????????
22
?????
23
?????
24
?????
25
carcinoma
1.papillary carcinoma 2.follicular
carcinoma 3.medullary carcinoma 4.anaplastic
carcinoma
26
?????
27
?????
28
?????
29
?????
30
???
31
???
32
????
33
??!