Courtney Takahashi
Pathology, Endocrine Path #2
Pituitary Adenoma
What percentage are prolactin (lactotroph)
adenomas? What are the symptoms?
What percentage are growth hormone
(somatotroph) adenomas? What are the
symptoms?
What percentage are ACTH (corticotroph)
adenomas? What are the symptoms?
What percentage is mixed GH/prolactin
(mammosomatotroph) adenomas?
What percent are gonadotroph adenomas?
What percent are thyroid stimulating hormone
cell (thyrotroph) adenomas?
What percent are null cell (hormone negative)
adenomas? Aka non-functional adenomas
What is the difference between
macroadenomas and microadenomas?
Normal thyroid gland
What is the function of parafollicular cells?
Where are they located?
What is a goiter? What are its 2 appearances?
What type of metabolic disease does it imply?
Thyroiditis
What is thyroiditis?
What sex is more commonly affected?
What are the associated genotype markers?
What is the usually disease progression?
What type of risk is associated with
thyroiditis?
What is one characteristic, microscopic finding
of thyroiditis?
What are end-stage microscopic findings?
Thyroid hyperplasia – Graves Disease
What population is most susceptible?
What is the classic triad?
What are 3 important histological findings?
Thyroid hyperplasia – Nodular
What is the etiology of nodular hyperplasia?
Clinical symptoms?
Gross appearance?
Papillary thyroid carcinoma
Epidemiological significance?
30%, amenorrhea, galatorrhea
17%, acromegaly, gigantism
15%, symptoms of Cushing’s disease
10%
3%
1%
25%
Macroadenoma – Enlarged pituitary gland with mass
effect
Microadenoma – Circumscribed nodule within pituitary
gland
Function: Produce calcitonin in the thyroid
Location: Between the follicles
Enlargement of the thyroid gland. Can appear nodular
or diffuse. Can indicate hyperfunctioning thyroid or
hypofunction.
Inflammation of the thyroid gland
Women
HLA-DR5, HLA-DR3
Initially thyrotoxic, later hypothyroid
Malignancy, both carcinoma and lymphoma
Oncocytic (Hurthle cell) metaplasia of follicular
epithelium
Destruction of follicles, fibrosis
Young women, age 20-40
Hyperthyroidism, ophthalmopathy, pretibial myxedema
Follicular hyperplasia with papillary infoldings, tall
columnar cells, “scalloping” of margins of colloid
within follicles
Idiopathic, usually euthyroid
Multiple nodules, often with one dominant nodule
Most common type of thyroid carcinoma
1
Which sex is more commonly affected? How
do they present?
What is one characteristic histological finding?
What is the prognosis?
Follicular adenoma
Do patients present with hyperthyroidism,
hypothyroidism or euthyroid?
What is the gross appearance?
Follicular carcinoma
What percent of all thyroid carcinomas are
follicular?
What demographic groups are at the highest
risk?
What is the definition of widely invasive?
What is the definition of minimally invasive?
Prognosis?
Medullary Carcinoma
What percent of all thyroid carcinomas?
What cells are they derived from?
What is one characteristic finding?
Parathyroid adenoma
What sex is more commonly affected? What
is the ratio?
Clinical presentation?
What is the predominant cell type?
Multiple Endocrine Neoplasia
What are the characteristics of MEN1?
What are the characteristics of MEN2A?
What are the characteristics of MEN2B?
Women, present with thyroid nodule (“cold nodule”)
Psammoma bodies (laminated calcifications)
Good prognosis, 10 year survival is 95%, 20 year
survival is 90%
Euthyroid
Usually solitary, encapsulated nodule
15-20% of thyroid carcinomas
Women and elderly
Extensive infiltration of normal thyroid or vascular
invasion
Capsular or vascular invasion present
Good prognosis. Spread is usually hemotogenous to the
lungs or bones
5-10% of thyroid carcinomas, sometimes associated
with MEN 2A or MEN 2B
Parafollicular cells, produce calcitonin
Amyloid within the stroma
Women, 3:1
Related to hypercalcemia due to PTH secretion
Chief cells
Parathyroid hyperplasia or adenoma, pituitary adenoma,
pancreatic islet cell tumor (commonly gastrinoma or
insulinoma)
Medullary carcinoma of the thyroid,
pheochromocytoma, parathyroid hyperplasia / adenoma
Medullary carcinoma of the thyroid,
pheochromocytoma, mucosal neuromas, skeletal
abnormalities, marfanoid appearance