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