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‫بسم هللا الرحمن الرحيم‬
THYROID GLAND
By
Dr. Ghada Ahmed
Lecturer of pathology
Benha Faculty of Medicine
Normal thyroid
Hypothalamic-pituitary-thyroid
axis
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.
Hypothyroidism
Clinical effects:

Cretinism
Hypothyroidism

Myxdema
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)
Hyperthyroidisim (Thyrotoxicosis)
Clinical features:
Cardiac manifestations
 Ocular manifestations
 Neuromuscular system
 Skin
 Gastrointestinal system
 Low serum TSH with
increased free serum T4.

Thyroiditis
Types:
 Hashimoto thyroiditis
 Subacute (granulomatous) thyroiditis
 Reidel thyroiditis
Hashimoto thyroiditis
Hashimoto thyroiditis
Subacute (granulomatous) thyroiditis

History of upper respiratory tract infection
Reidel thyroiditis



Rare disease.
Unknown etiology.
Extensive fibrosis of thyroid and
surrounding neck structures.
Graves disease
Pathogenesis

It results from autoantibodies to TSH
receptor, (long acting thyroid stimulator
(LATS))
activate the surface
receptors for TSH on thyroid epithelium.
Graves disease



Pathogenesis
Gross picture
Microscopic picture
Graves disease
Graves disease

Clinical effects
Goiters

Definition

Goitrogens
Types of Goiter
Diffuse
(non toxic)
Goiter
Multinodular
(toxic / non
toxic)
Endemic
Sporadic
Diffuse nontoxic (simple) goiter






Endemic form
Sporadic form
Morphology:
Hyperplastic stage
Colloid involution stage
Most patients are clinically euthyroid.
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).
Multinodular goiter
(Nodular colloid goiter)
Multinodular goiter
(Nodular colloid goiter)
Tumors of the thyroid gland
A) Benign tumors:
Follicular adenoma

B) Malignant tumors
Thyroid carcinoma

Benign tumors
thyroid follicular adenoma
Benign tumors
thyroid follicular adenoma






Microscopic picture:
various histologic subtypes
according to degree of follicle formation and colloid content:
12345-
Colloid adenoma (macrofollicular).
Fetal adenoma (microfollicular).
Embryonal adenoma.
Hϋrthle cell adenoma.
Atypical adnoma.
Benign tumors
thyroid follicular adenoma
Thyroid follicular adenoma

Clinical effects:
Thyroid carcinoma




Papilary carcinoma
Follicular carcinoma
Medullary carcinoma
Anaplastic carcinoma
Papillary carcinoma
Papillary carcinoma
Follicular carcinoma
Follicular carcinoma
Capsular invasion in follicular carcinoma
Vascular invasion in follicular carcinoma
Medullary carcinoma
Medullary carcinoma
Anaplastic carcinoma
Anaplastic carcinoma
Thyroid Nodule
Thyroid
nodule
Nonneoplastic
Nodular
colloid
goiter
Hashimoto
thyroiditis
Neoplastic
Adenoma
carcinomas