Medullary Carcinoma Thyroid Gland Histopathology

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Hashimoto’s thyroididtis • ***Follow me**** • http://ilovepathology.com/ • Twitter : / vijaypatho • / ilovepathology2 • Facebook: / ilovepathology • • Most common cause of hypothyroidism in areas where iodine levels are sufficient. • Gradual thyroid failure due to autoimmune destruction of thyroid gland • Definition: • It is Characterized by • 1. Diffuse goitrous enlargement of the thyroid • 2. Lymphocytic infiltration of the thyroid gland • 3. Presence of thyroid autoantibodies. • • Age incidence: 45 - 65yrs. • Male: Female: 1:10 to 1:20 • It can occur in children and is a major cause of nonendemic goiter in children. • • • 1. Genetic predisposition. • 2. Immune causes: Autoantibody production • 3. Environmental factors: In a genetically susceptible individual environmental factors, such as infection, dietary factors (iodine), stress and pregnancy, may initiate autoimmunity in the thyroid. • Genetic predisposition:HLA-DR3 DR5 • Immune causes • Immune Regulatory Genes • [CTLA4, PTPN22] • cytotoxic T lymphocyte–associated antigen-4 (CTLA4) • protein tyrosine phosphatase-22 • Thyroid specific genes • (thyroglobulin and thyroid-stimulating hormone [TSH] receptor ) • GROSS • -Diffuse enlargement , may be Nodular • Gland well demarcated • Cut section; Pale, yellow tan, rubbery to firm/nodular • MICRO • Atrophy of the follicles • Diffuse infiltration by mononuclear cells • Formation of lymphoid follicles • Hurthle cell metaplasia • Interstitial connective tissue may be increased • Clinical features : Middle aged women • Painless enlargement • Variable degree of • hypothyroidism • Laboratory findings: T3 T4 decreased • TSH increased • Antithyroid antibodies • Diagnostic tests: FNAC • HPE of Biopsy • • COMPLICATIONS • Hashitoxicosis • B-cell Non Hodgkin Lymphoma • Increased risk for other autoimmune diseases • Diabetes type 1, Adrenalitis, SLE, Myasthenia Gravis.. • Increased risk(variable) thyroid epithelial neoplasms.. Papillary Carcinoma • ~-~~-~~~-~~-~ • Please watch: WARBURG EFFECT: Hallmark of CANCER. What, Why How? • • NEOPLASIA 6: WARBURG EFFECT: Hallmark... • ~-~~-~~~-~~-~

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