Disorders of the Thyroid gland

J.Rohini

Benign Hashimoto thyroiditis Hypothyroidism Graves’ disease

MalignantPapillary carcinomaFollicular carcinomaHurthle cell tumor Medullary Thyroid

Carcinoma Anaplastic CarcinomaLymphoma of thyroid

Hashimoto thyroiditisAutoantibodies(TPO and Tg antibodies)

Thyroid inflamation with destruction of thyroid tissue and fibrosis

Raised TSH level

Multiple micronodules or large nodule

Responds to exogenous thyroid

Hypothyroidism-Etiology

Iodine deficiency(most common)Hashimoto diseaseTotal or subtotal thyroidectomyRadiation exposure

SymptomsFatigue Intolerance to coldHoarsenessPoor memoryWeight gainConstipationHearing loss

SignsDry and coarse skinPuffy faceLoss of hair Bradycardia

Graves’ diseaseAutoimmune disorderAbs directed against TSH receptor with

intrinsic activity.Responsible for 60-80% of

ThyrotoxicosisMore common in womenDia:TSH suppressed, T4 raised

Papillary carcinomaMost commonDevelops from thyroid follicle cellsUnencapsulated but often have a pseudocapsuleHistology - psammoma bodies - nuclei are oval or elongated, pale

staining with ground glass appearance- Orphan Annie cells

Follicular carcinomaSolid invasive tumors, usually solitary

and encapsulatedDevelops from thyroid follicular cellsIt presents as solitary thyroid noduleDia :FNAC-evidence of vascular and

capsular invasion

Hurthle cell carcinomaSyn :oncocytic carcinomaOncocytes are large cells which are rich

in mitochondria and stain pinkMore aggressive than follicular

carcinomaDia :FNAC shows hurthle cells

Anaplastic carcinomaExtremely aggressive and exceptionally

virulentComposed wholly or in part of

undifferentiated cellsTumor is typically hard, poorly

circumscribed

Medullary carcinomaTumour arising from the calcitonin-

secreting C-cells of the thyroid glandAssociated with MEN IIa MEN IIbMetastases usually contain calcitonin

and stain for amyloid

Lymphoma

A rare type of thyroid cancerDevelops in the setting of pre-existing

lymphocytic thyroiditisTumors are firm, fleshy, and usually pale