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

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Presentation on theme: "بسم الله الرحمن الرحيم THYROID GLAND By Dr. Ghada Ahmed Lecturer of pathology Benha Faculty of Medicine."— Presentation transcript:

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: Hyperfunctional multinodular 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

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 Clinical effects

18 Goiters Definition Goitrogens

19 Types of Goiter Goiter Diffuse (non toxic) Endemic Sporadic Multinodular (toxic / non toxic)

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

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

25 Benign tumors thyroid follicular adenoma

26 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 tumors thyroid follicular adenoma

28 Thyroid follicular adenoma Clinical effects:

29 Thyroid carcinoma Papilary carcinoma Follicular carcinoma Medullary carcinoma Anaplastic carcinoma

30 Papillary carcinoma

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32 Follicular carcinoma

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34 Capsular invasion in follicular carcinoma

35 Vascular invasion in follicular carcinoma

36 Medullary carcinoma

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38 Anaplastic carcinoma

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40 Thyroid Nodule Thyroid noduleNon-neoplastic Nodular colloid goiter Hashimoto thyroiditis NeoplasticAdenomacarcinomas

41


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