Hyperthyroidism
Author:
Mikael Häggström [note 1]
Fixation
Generally 10% neutral buffered formalin. Fix all thyroids at least overnight to avoid artifactual nuclear atypia.[1]
See also: General notes on fixation
Template:Gross processing of thyroid
Microscopic evaluation
The most common cause of hyperthyroidism is Grave's disease (50-80% worldwide). Its typical features are:[2]
- 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
- Colloid is typically decreased, 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.[3]
- 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.[3]- Also potentially papillary projections (Sanderson polsters) that may mimic papillary carcinoma, but they lack malignant nuclear features.[3]
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
Main page
References
- ↑ . 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
- ↑ 3.0 3.1 3.2 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
Image sources