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MODULE 15- ENDOCRINE SYSTEM (PATHOLOGY)

PRACTICAL PATHOLOGY : GOITER

A)Jars:-

1.Organ: Thyroid Gland (Page 118-Atlas of Gross Pathology)

Description:

The thyroid gland is

- markedly enlarged and grossly nodular

- on section, cut surface is nodular and variegated ( variety of colours) in

appearance showing

focal areas of brownish translucent colloid

brownish areas of hemorrhage

whitish areas of fibrosis and calcificationDiagnosis: Colloid nodular goiter

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2. Organ: Thyroid gland (Page 119)

Description:

- The thyroid gland is diffusely enlarged with preserved shape

- On section, cut surface is tan coloured and pancreatic like in

appearance.

Diagnosis: Primary thyrotoxicosis (Graves disease)

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3. Organ : Thyroid gland (Page 120)

Description :

- The thyroid gland is enlarged and grossly nodular.

- On section, cut surface is nodular and variegated (variety of colours) in

appearance.

- In one area, a non-encapsulated grayish white mass lesion is detected.

Diagnosis: Carcinoma of thyroid gland and colloid nodular goiter.

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B) Slides :-

1. Colloid nodular goiter (Page 108 -Atlas of Histopathology)

Section revealed nodular thyroid tissue formed of:

- Colloid distended follicles of different sizes and shapes some reachinglarge

- The lining epithelium is low cuboidal to flattened.

- Traversing fibroconnective tissue bands.

- Focal stromal fibrosis and areas of fresh and old hemorrhages.

- Focal stromal calcifications and cholesterol clefts.

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2. Toxic goiter, Thyroid (page109)

Section in thyroid gland showing:

- Numerous follicles of varying sizes and shapes most of which are small.

- The lining epithelium is hyperplastic and shows occasional papillary

formation.

- Some of the follicles are empty and others are filled with pale staining

colloid showing peripheral scalloping.

- The stroma in between the follicles shows numerous congested

vascular spaces and focal lymphocytic infiltration.

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3. Hashimoto thyroiditis, thyroid (page 110)

Section in thyroid gland showing:

- Thyroid follicles mostly of small size.

- The follicles are lined by epithelial cells showing abundant eosinophiliccytoplasm and vesicular nuclei (Hurthle cells)

- The surrounding stroma is infiltrated by numerous lymphocytes and

plasma cells.

- In areas, lymphoid follicle formation showing reactive germinal centers

are detected.

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4. Papillary Carcinoma of thyroid gland (page 113)

Thyroid tissue infiltrated in one area by tumor tissue formed of:

- Complex papillary fronds covered by carcinomatous cells showing

crowded

overlapping ground glass nuclei showing intranuclear inclusions.

- Underlying fibrovascular connective tissue cores.

- In areas, psammoma bodies are detected.