Hyperthyroidism: Difference between revisions
Jump to navigation
Jump to search
→Microscopic evaluation: +Findings |
m →Microscopic evaluation: Formatting |
||
| Line 19: | Line 19: | ||
File:Histopathology of Graves' disease - low mag.jpg|'''Graves' disease''' - low magnification: exuberant papillary hyperplasia. | File:Histopathology of Graves' disease - low mag.jpg|'''Graves' disease''' - low magnification: exuberant papillary hyperplasia. | ||
File:Histopathology of Graves' disease - medium mag.jpg|'''Graves' disease''' - medium magnification: cells with round nuclei and even chromatin pattern lining the papillae. | File:Histopathology of Graves' disease - medium mag.jpg|'''Graves' disease''' - medium magnification: cells with round nuclei and even chromatin pattern lining the papillae. | ||
File:Histopathology of multinodular toxic goiter.jpg|'''Toxic multinodular goiter''', whose typical findings are:<br>- Variably dilated follicles with flattened hyperplastic epithelium.<ref name=POMultinodular>{{cite web|url=http://www.pathologyoutlines.com/topic/thyroidnodular.html|title=Thyroid gland - Hyperplasia / goiter - Multinodular goiter|website=PathologyOutlines|author=Swati Satturwar, M.B.B.S., F. Zahra Aly, M.D., Ph.D.}} Topic Completed: 1 February 2018. Minor changes: 14 December 2019</ref><br>- Nodules may be present (but lack thick capsule in contrast to adenomas).<b>-Potentially focal fresh or old hemorrhages, rupture of follicles with granulomatous inflammation, fibrosis, calcification and even osseous metaplasia.<ref name=POMultinodular/> | File:Histopathology of multinodular toxic goiter.jpg|'''Toxic multinodular goiter''', whose typical findings are:<br>- Variably dilated follicles with flattened hyperplastic epithelium.<ref name=POMultinodular>{{cite web|url=http://www.pathologyoutlines.com/topic/thyroidnodular.html|title=Thyroid gland - Hyperplasia / goiter - Multinodular goiter|website=PathologyOutlines|author=Swati Satturwar, M.B.B.S., F. Zahra Aly, M.D., Ph.D.}} Topic Completed: 1 February 2018. Minor changes: 14 December 2019</ref><br>- Nodules may be present (but lack thick capsule in contrast to adenomas).<b>- Potentially focal fresh or old hemorrhages, rupture of follicles with granulomatous inflammation, fibrosis, calcification and even osseous metaplasia.<ref name=POMultinodular/><b>- Also potentially papillary projections (Sanderson polsters) that may mimic papillary carcinoma, but they lack malignant nuclear features.<ref name=POMultinodular/> | ||
Also potentially papillary projections (Sanderson polsters) that may mimic papillary carcinoma, but they lack malignant nuclear features.<ref name=POMultinodular/> | |||
File:Histopathology of amiodarone associated follicular cell damage - high mag.jpg|'''Amiodarone associated follicular cell damage''' - high magnification: large thyroid follicles filled with colloid and numerous histiocytes | File:Histopathology of amiodarone associated follicular cell damage - high mag.jpg|'''Amiodarone associated follicular cell damage''' - high magnification: large thyroid follicles filled with colloid and numerous histiocytes | ||
File:Histopathology of amiodarone associated follicular cell damage - low mag.jpg|'''Amiodarone associated follicular cell damage''' - low magnification: large thyroid follicles filled with colloid and numerous histiocytes (arrow heads) | File:Histopathology of amiodarone associated follicular cell damage - low mag.jpg|'''Amiodarone associated follicular cell damage''' - low magnification: large thyroid follicles filled with colloid and numerous histiocytes (arrow heads) | ||
Revision as of 18:14, 9 July 2020
Author:
Mikael Häggström [note 1]
Fixation
Generally 10% neutral buffered formalin. Fix all thyroids at least overnight to avoid artifactual nuclear atypia.[1]
See also: General notes on fixation
Template:Gross processing of thyroid
Microscopic evaluation
The most common cause of hyperthyroidism is Grave's disease (50-80% worldwide). Its typical features are:[2]
- Hyperplastic thyroid follicles with papillary infoldings
- Diffuse hyperplasia and hypertrophy of follicular cells with retention of lobular architecture
- Prominent vascular congestion
- Tall follicular cells with papillae that usually lack fibrovascular cores
- Nuclei are round, often basally located, and rarely overlap
- Colloid is typically decreased, and when present it typically has peripheral scalloping
- Variable patchy lymphoid stromal infiltrate
-
Graves' disease - low magnification: exuberant papillary hyperplasia.
-
Graves' disease - medium magnification: cells with round nuclei and even chromatin pattern lining the papillae.
-
Toxic multinodular goiter, whose typical findings are:
- Variably dilated follicles with flattened hyperplastic epithelium.[3]
- Nodules may be present (but lack thick capsule in contrast to adenomas).- Potentially focal fresh or old hemorrhages, rupture of follicles with granulomatous inflammation, fibrosis, calcification and even osseous metaplasia.[3]- Also potentially papillary projections (Sanderson polsters) that may mimic papillary carcinoma, but they lack malignant nuclear features.[3] -
Amiodarone associated follicular cell damage - high magnification: large thyroid follicles filled with colloid and numerous histiocytes
-
Amiodarone associated follicular cell damage - low magnification: large thyroid follicles filled with colloid and numerous histiocytes (arrow heads)
-
Papillary hyperplastic nodule - high magnification: oncocytic cells lining the papillary structures (arrow)
-
Papillary hyperplastic nodule - low magnification: cystic nodule with papillary architecture (arrow)Papillary hyperplastic nodule - low magnification: cystic nodule with papillary architecture (arrow)
![Toxic multinodular goiter, whose typical findings are: - Variably dilated follicles with flattened hyperplastic epithelium.[3] - Nodules may be present (but lack thick capsule in contrast to adenomas).- Potentially focal fresh or old hemorrhages, rupture of follicles with granulomatous inflammation, fibrosis, calcification and even osseous metaplasia.[3]- Also potentially papillary projections (Sanderson polsters) that may mimic papillary carcinoma, but they lack malignant nuclear features.[3]](/index.php?title=Special:Upload&wpDestFile=Histopathology_of_multinodular_toxic_goiter.jpg){kind=link}
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
Main page
References
- ↑ . Gross Pathology Manual By The University of Chicago Department of Pathology. Updated 2-14-19 NAC.
- ↑ F. Zahra Aly, M.D., Ph.D., Swati Satturwar, M.B.B.S.. Thyroid gland - Hyperplasia / goiter - Graves disease. PathologyOutlines. Topic Completed: 1 November 2017, Minor changes: 14 March 2019
- ↑ 3.0 3.1 3.2 Swati Satturwar, M.B.B.S., F. Zahra Aly, M.D., Ph.D.. Thyroid gland - Hyperplasia / goiter - Multinodular goiter. PathologyOutlines. Topic Completed: 1 February 2018. Minor changes: 14 December 2019
Image sources