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بسم الله الرحمن الرحيم

بسم الله الرحمن الرحيم. THYROID GLAND By Dr. Ghada Ahmed Lecturer of pathology Benha Faculty of Medicine. Normal thyroid. Hypothalamic-pituitary-thyroid axis. Hypothyroidism. Primary hypothyroidism T hyroiditis : Hashimoto autoimmune thyroiditis D ietary iodine deficiency.

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بسم الله الرحمن الرحيم

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  1. بسم الله الرحمن الرحيم THYROID GLAND By Dr. Ghada Ahmed Lecturer of pathology Benha Faculty of Medicine

  2. Normal thyroid

  3. Hypothalamic-pituitary-thyroid axis

  4. Hypothyroidism • Primary hypothyroidism • Thyroiditis :Hashimoto autoimmune thyroiditis • Dietary iodine deficiency. • Drugs that block thyroid hormone synthesis. • Thyroid surgery or radiation. • Secondary hypothyroidism: usually caused by TSH deficiency.

  5. Hypothyroidism Clinical effects: • Cretinism

  6. Hypothyroidism • Myxdema

  7. Hyperthyroidisim (Thyrotoxicosis) • Primary hyperthyroidism: • Graves disease (autoimmune)(85% of cases). • Goiter: Hyperfunctionalmultinodular goiter. • Adenoma: Hyperfunctional adenoma of thyroid. • Secondary hyperthyroidism: • Pituitary adenoma. • Inappropriate intake of exogenous hormone (as a treatment for hypothyroidism)

  8. Hyperthyroidisim (Thyrotoxicosis)Clinical features: • Cardiac manifestations • Ocular manifestations • Neuromuscular system • Skin • Gastrointestinal system • Low serum TSH with increased free serum T4.

  9. Thyroiditis Types: • Hashimoto thyroiditis • Subacute (granulomatous) thyroiditis • Reidel thyroiditis

  10. Hashimoto thyroiditis

  11. Hashimoto thyroiditis

  12. Subacute (granulomatous) thyroiditis • History of upper respiratory tract infection

  13. Reidel thyroiditis • Rare disease. • Unknown etiology. • Extensive fibrosis of thyroid and surrounding neck structures.

  14. Graves disease Pathogenesis • It results from autoantibodies to TSH receptor, (long acting thyroid stimulator (LATS)) activate the surface receptors for TSH on thyroid epithelium.

  15. Graves disease • Pathogenesis • Gross picture • Microscopic picture

  16. Graves disease

  17. Graves disease • Clinical effects

  18. Goiters • Definition • Goitrogens

  19. Types of Goiter

  20. Diffuse nontoxic (simple) goiter • Endemic form • Sporadic form • Morphology: • Hyperplastic stage • Colloid involution stage • Most patients are clinically euthyroid.

  21. Multinodular goiter (Nodular colloid goiter) • Repeated cycles of stimulation and involution of a diffuse goiter • Pressure symptoms • It may be non-toxic or may induce thyrotoxicosis (toxic multinodular goiter).

  22. Multinodular goiter (Nodular colloid goiter)

  23. Multinodular goiter (Nodular colloid goiter)

  24. Tumors of the thyroid gland • A) Benign tumors: Follicular adenoma • B) Malignant tumors Thyroid carcinoma

  25. Benign tumorsthyroid follicular adenoma

  26. Benign tumorsthyroid follicular adenoma • Microscopic picture: various histologic subtypes according to degree of follicle formation and colloid content: • 1- Colloid adenoma (macrofollicular). • 2- Fetal adenoma (microfollicular). • 3- Embryonal adenoma. • 4- Hϋrthle cell adenoma. • 5- Atypical adnoma.

  27. Benign tumorsthyroid follicular adenoma

  28. Thyroid follicular adenoma • Clinical effects:

  29. Thyroid carcinoma • Papilary carcinoma • Follicular carcinoma • Medullary carcinoma • Anaplastic carcinoma

  30. Papillary carcinoma

  31. Papillary carcinoma

  32. Follicular carcinoma

  33. Follicular carcinoma

  34. Capsular invasion in follicular carcinoma

  35. Vascular invasion in follicular carcinoma

  36. Medullary carcinoma

  37. Medullary carcinoma

  38. Anaplastic carcinoma

  39. Anaplastic carcinoma

  40. Thyroid Nodule

  41. Thank you

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