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