Causes Thyroid swelling: Hyperthyroidism. Hypothyroidism. Non – toxic goitre. Auto – immune thyroid disease. Thyroiditis both local and chronic. Thyroid tumour : adenoma and carinoma.

Thyroid hormones and functions: Thyroxine T4. Tri aodothyronine T3. Calcitonin. T4 and T3 are needed by all cells for

metabolism process. Calcitonin : regulate serum calcium by

lowering its level.

Non – toxic nodular goitre. : It is the commonest lesion in thyroid

pathology and reflects compenesatory thyroid hyperplasia because of absolute or relative iodine deficiency.

Goitre can be endemic or sporadic

Endemic goitre: Occurs in children and less in female. Occurs in mountinainous areas. or in areas

far from sea e.g. Gebel Mara . Sporadic non –toxic goitre Causes : Due to relative lack of iodine in individualsPatients. Could be due to poor dietary intake Or from inherited deficiency of the various

enzymes involved in the biosynthesis of T4.

Or from ingestion of specific chemicals e.g. :cabbage , excessive fluoride in water more common in females.

It presents at puberty or at pregnancy and lactation.

Clinical presentation: Clinicaly patient is euthyroid with a slight

increase in TSH It can be colloid goitre.or multinodular

goitre. It may compress the recurrent laryngeal nerve causing coarse voice or trachea causing difficult breathing.

Or the oesophageal cause dysphagia. Cosmotic Become toxic.

Auto immune thyroid disease include”: Hashimoto. Primary myxoedema. Graves dis.

Characterised by: The presence of circulating auto antibodies

the various components of thyroid follicular cells.

These play an active role in the pathogenesis of the dis.

Thyroid stimulating immunoglobulins (TSI) TSH receptor antibodies results in

hyperthyroidism (Graves dis.)while blocking antibodies with TSH receptor contribute to hypothyroidism primary myxoedema and Hashimoto s dis.

Thyrid tumour : Can occur from both follicular epithelial and

C cells . Majority are follicular adenoma. Malignant tumour divided into: Papillary and follicular carinoma. Medullary carinoma from C cells.

Follicular Adenoma: Seen in women over 30 yrs may cause

hyperthyrodism (toxic adenoma) Encapsulated and compress the

surrounding normal gland. Hemorrhage, degenerative changes and

fibrosis.

Papillary carcinoma: 60 – 70 % occur in young adults(30 – 40)

yrs. More common in female . It spreads by lymphatic . Size is small can be known by enlarged

lymph node.Follicular carcinoma: 15 – 20 % of all thyroid cancers but in areas

of endemic goitre.