The pathology of the thyroid gland introduction the thyroid gland is the largest gland located in the neck. Based on ajccuicc tnm, 7th edition protocol web posting date. Parathyroid gland introduction the paired parathyroid glands are typically located on the anterolateral edge of the thyroid glands. The goal of this article is to discuss the embryology, anatomy, brief histology, and neurovascular supply of the thyroid gland. Consulting surgeon to mary thompson hospital and illinois charitable eye and ear infirmary, etc. Pathology of the thyroid gland 3 flashcards quizlet. However, large lymphoid infiltrates are characteristic of that spectrum of diseases conveniently termed chronic lymphocytic thyroiditis. It weighs approximately 15 to 20 grams in the adult human. The normal adult thyroid gland weighs about 1525 grams. Whose new in thyroid gland pathology 6 31 32 33 niftp. The thyroid gland has the shape of a butterfly with the two wings being characterized by the left and. Protocol applies to all carcinomas of the thyroid gland.
Introduction thyroid disorder is a general term representing several different diseases involving thyroid hormones and the thyroid gland. The thyroid is a butterflyshaped gland located in the front of the neck just above the trachea. Most patients with hyperthyroidism have an enlarged thyroid gland goiter, but characteristics of the enlargement vary. If the gland is already pathologically abnormal nodular thyroid goiter, graves disease, the pathology of the resected gland shows follicular disruption with histiocytes infiltrating the follicular epithelium and colloid figures figures5, 5,6. Autoimmune disease characterized by hyperthyroidism due to circulating autoantibodies against thyrotropin tsh receptor that activates the receptor leading to increased thyroid hormone synthesis and secretion and growth of the thyroid gland presence of thyrotropin receptor antibody in the serum and ophthalmopathy on clinical.
Anatomy, physiology and pathology of the thyroid gland. The overall incidence of this particular form of thyroid cancer is rising, for reasons that remain unclear but that in part may reflect earlier diagnosis. The cytopathology of the thyroid gland is dealt with in the thyroid cytology article. Preliminary stuff lecture information endocrine pathology pathology for dental students lamp 5100 university of minnesota school of dentistry lecturer kristine krafts, m. Hyperthyroidism, excess production of thyroid hormone by the thyroid gland. The neuroendocrine lesions of the thyroid are few in number and include ccell lesions ccell hyperplasia and medullary carcinoma, mixed ccell and follicularderived tumors, paraganglioma, intrathyroidal parathyroid adenoma, and metastasis to the thyroid from neuroendocrine carcinoma arising elsewhere. These include hyperplasia, which may be associated with increased hormonesynthesizing activity or with increased demand for thyroid hormone, inflammation, fibrosis and neoplasia.
Insert thyroid diffuse or insert thyroid nodule triage. Granular cell tumor of the thyroid archives of pathology. Metastases of extrathyroid tumours mts to the thyroid gland are rare. If you continue browsing the site, you agree to the use of cookies on this website. The gland has two lobes connected by a narrow isthmus, and is located just anterior to the larynx and trachea. The thyroid gland is subdivided by capsular septa into lobules containing follicles. Examples of thyroid disorders that give rise to hyperthyroidism include. Parathyroid gland is formed by four nodules originated from the third and fourth branchial arches, two at thyroid s right and left lobes apex and the remaining two on lower poles. Small aggregates of lymphoid cells are present at multiple sites between follicles. A normal test result is 5% to 15% of the dose taken up within 5 hours and 15% to 35% within 24 hours. Disorders of the thyroid gland essentially fall into two basic categories. It is positioned in the anterior or front of the neck below the skin and muscle layers.
Rarely, inflammatory cells are noted within the thyroid parenchyma type i. Lymphomas, sarcomas and metastases are not included. Fibrous variant of hashimotos thyroiditis is a rare condition occurring in about 10% cases, mainly middle age people. Topography variations are common, because they are sometimes located next to larynx with no correlation to thyroid, and can be found up to mediastinum. Papillary thyroid cancer ptc ptcs represent approximately 80% of all thyroid malignancies.
Thyroid disorders are commonly separated into two major categories, hyperthyroidism and hypothyroidism, depending on whether serum thyroid hormone. Hypothyroidism is a condition in which the thyroid gland is under active and produces too little thyroid hormone. Endocrine disease lead to dysregulated levels of thyroid hormones, termed hyperthyroidism excess hormone or hypothyroidism insufficient hormone. A pyramidal lobe may be present projecting upward from the isthmus. The pathology of the thyroid gland 2837 words bartleby. Ancillary immunohistochemistry can aid in differentiating tumour types and has also been used to support a diagnosis of malignancy in equivocal follicular. Congenital primary hypothyroidism is caused by lack of or abnormal development of the thyroid in utero and inherited defects in the synthesis of thyroid hormone. This chapter will discuss diseases of the pituitary gland hyperpituitarism, hypopituitarism, mass effect as related to pituitary gland lesions, and posterior pituitary gland pathology, diseases of the thyroid gland goiter, hyperthyroidism, hypothyroidism, thyroiditis, and thyroid neoplasms, diseases of the parathyroid glands hyperparathyroidism and hypoparathyroidism, diabetes mellitus. As a rule these are slowgrowing tumors that lead to progressive disease relatively infrequently. The gland weight is 1525 g in adults, is heavier in females and varies during pregnancy, iodine intake and other pathological conditions. Neuroendocrine tumors of the thyroid gland pathology. Figure 1 thyroid gland inflammation, chronic in a female tg.
This test is primarily used for diagnosis of graves disease increased uptake. The thyroid produces and releases into the circulation at least two potent hormones, thyroxine t4 and triiodothyronine t3, which influence basal metabolic processes andor enhance oxygen consumption in nearly all body tissues. It is surrounded by a dense irregular collagenous connective tissue capsule, in which posteriorly the parathyroid glands are embedded. It is characterized by an extensive fibrous proliferation without extension into the surrounding structures. Lymphoid cells are seen in the stroma of glands affected by graves disease. She presented a voluminous goiter of hard consistence, dyspnea. Examples benign, consistent with adenomatoid nodule by ed euthman papillary carcinoma of the thyroid gland.
It affects all age groups, although it is rare in children. Atlas of head and neck pathology thyroid follicular adenoma table of contents previous next thyroid follicular adenoma benign thyroid follicular tumors are designated as follicular adenomas. Further details regarding thyroid hormone synthesis and the key functions of the gland will also be addressed. Us has largely replaced the need for thyroid scintigraphy except to detect iodineavid thyroid metastases after thyroidectomy and to identify hyperfunctioning toxic thyroid nodules. Learn vocabulary, terms, and more with flashcards, games, and other study tools. In recent years, a series of excellent textbooks have been published dealing with pathology of the thyroid gland. The patients included 79 women and 29 men, with an average age of 64. These septa also serve as conduits for blood vessels. Thyroid enlargement, or goitre, may result from a variety of changes. Pathology of the pituitary, parathyroid, thyroid and. Lymphocytic infiltration of the thyroid gland is the pathologic hallmark of autoimmune thyroid disease. Malignant counterparts traditionally have been divided into two major categories, follicular.
However, they are encountered in diagnostic surgical pathology as well as in fna cytology and can have very misleading morphology. Diseases of thyroid gland discussed for mbbs students. Papillary thyroid carcinoma is the most common thyroid malignancy. They include both nonneoplastic and neoplastic disorders. Abnormalities of the thyroid gland are the most common lesions encountered in surgical pathology practice. Dipak shah department of pathology uwi, mona slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. The thyroid gland is an important little endocrine organ in the anterior neck.
Hypothyroidism usually results from a disorder of the thyroid gland, in which case it is described as primary hypothyroidism. The thyroid gland is composed of 2 lobes connected by an isthmus. A 55yearold female was referred to our department for an unexplained onset of cervical discomfort. Fibrous variant of hashimotos thyroiditis as a diagnostic. This was found to represent a granular cell tumor that was densely adherent to the trachea, rather than an actual thyroid.
The present volume of current topics in pathology provides further information for both pathologists and clinicians interested in the thyroid gland. Professor of surgery in postgraduate hospital of chicago. Sulaiman, md, fcap medical director of laboratories. Pathology of thyroid gland free download as powerpoint presentation. A quick runthrough of the most important points from my thyroid pathology lecture at the university of minnesota school of medicine, duluth, which has the best medical students in the world. This article is part of the five top stories in anatomic. We report a retrospective clinicopathologic study of 108 primary thyroid gland lymphomas ptls, classified using the real and proposed who classification schemes. A needle biopsy taking a sample of tissue or needle aspiration taking a sample of fluid from nodules in the thyroid gland can also be done by a physician. Discussion of disorders of the thyroid gland can be found in a subsequent article. The literature also records a granular cell tumor that presented as a paratracheal mass.
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