department of pathology li shuhua. nontoxic goiter toxic goiter adenoma adenocarcinoma
TRANSCRIPT
Department of pathology Li shuhua
nontoxic goiter
Toxic goiter
adenoma
adenocarcinoma
Diffuse nontoxic goiter
Pathogenesis:
Dietary iodine deficiency endemic
Not apparent sporadic
Impaired synthesis of thyroid hormone
Rise TSH level in serum Hypertrophy and hyperplasia of thyroid follicular cells
Gross enlargement of the thyroid gland
morphology
Diffuse hyperplastic goiter
Diffuse colloid goiter
Nodular goiter
Diffuse hyperplastic goiter
1. Diffuse , symmetric enlargement of the gland; <150g
2. follicle are lined by crowded columnar cells, which may pile up and form projections. There is only little colloid in the follice
非毒性甲状腺肿
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.
非毒性弥漫性甲状腺肿
Nodular goiter
macroscopically:
• Multilobulated, asymmetrically enlarged glands
• Cut surface: irregular nodules containing variable amount of brown,gelatinous colloid;
microscopically
1. Regressive changes: fibrosis, hemorrhage, calcification, cystic
2. Colloid-rich follicles lined by flattened epithelium and areas of follicular epithelial hypertrophy and hyperplasia;
非毒性结节性甲状腺肿
Diffuse toxic goiter
(grave’s disease)
Pathogenesis:
autoimmune disorder
Morphology:
1.diffusely enlarged, gland is smooth and soft,capsule is intact
2.microscopically: follicular epithelial cells are tall,columnar ,crowed, formation of small papillae; colloid is pale with scalloped margins.
3.vessel and lymphoid aggregates
甲状腺机能亢进
Clinical features
diffuse hyperplasia of the thyroid, ophthalmopathy, dermopathy
甲状腺肿大
突眼
adenomas
1.solitary, spherical, encapsulated lesion
2.cut surface:gray 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
甲状腺腺瘤
滤泡性甲状腺腺瘤
胚胎性腺瘤
胎儿型腺瘤
嗜酸性腺瘤
carcinoma
1.papillary carcinoma
2.follicular carcinoma
3.medullary carcinoma
4.anaplastic carcinoma
乳头状腺癌
乳头状腺癌
滤泡性腺癌
滤泡性腺癌
髓样癌
髓样癌
未分化癌