Generally 10% neutral buffered formalin. Fix all thyroids at least overnight to avoid artifactual nuclear atypia.
See also: General notes on fixation
As per standard for thyroid.
The most common cause of hyperthyroidism is Grave's disease (50-80% worldwide). Its typical features are:
- Hyperplastic thyroid follicles with papillary infoldings.
- Diffuse hyperplasia and hypertrophy of follicular cells with retention of lobular architecture.
- Prominent vascular congestion.
- Tall follicular cells with papillae that usually lack fibrovascular cores.
- Nuclei are round, often basally located, and rarely overlap.
- Typically decreased colloid amount, and when present it typically has peripheral scalloping.
- Variable patchy lymphoid stromal infiltrate.
Toxic multinodular goiter, whose typical findings are:
- Variably dilated follicles with flattened hyperplastic epithelium.
- Nodules may be present (but lack thick capsule in contrast to adenomas).
- Potentially focal fresh or old hemorrhages, rupture of follicles with granulomatous inflammation, fibrosis, calcification and even osseous metaplasia.
- Also potentially papillary projections (Sanderson polsters) that may mimic papillary carcinoma, but they lack malignant nuclear features.
- . Gross Pathology Manual By The University of Chicago Department of Pathology. Updated 2-14-19 NAC.
- F. Zahra Aly, M.D., Ph.D., Swati Satturwar, M.B.B.S.. Thyroid gland - Hyperplasia / goiter - Graves disease. PathologyOutlines. Topic Completed: 1 November 2017, Minor changes: 14 March 2019
- Swati Satturwar, M.B.B.S., F. Zahra Aly, M.D., Ph.D.. Thyroid gland - Hyperplasia / goiter - Multinodular goiter. PathologyOutlines. Topic Completed: 1 February 2018. Minor changes: 14 December 2019