#Microscopic 

#Diagnosis 👉🏻  Hashimoto


#The_green_arrow
Lymphoid follicles

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Germinal center

#The_blue_areas
Hurthle cell

#The_white_arrows
Lymphocytic infiltrate

#The_red_area
Atrophied Follicles without colloid

#The_yellow_area
Atrophied Follicles with colloid

#The_features
- atrophic lymphoid follicles with Hurthle cell but no or reduced colloid
- diffuse lymphocytic infiltrate


"" نوع lymphocytic يكون  T cells and plasma cells ""

#Microscopic 

#Diagnosis 👉🏻  Riedel thyroiditis


#The_black_arrows
Dense fibrosis

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Chronic inflammatory cell infiltrate

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Atrophied Follicles

#The_features
In the gross
- Stony hard due to fibrosis
- Tan or gray, woody
- avascular, no lobules apparent (adherant)
- Painless

In the Microscopic
- No normal lobular pattern
- Atrophied Follicles due to compression of dense fibrous tissue( pink color), which also infiltrates adjacent skeletal muscle
- Patchy lymphocytes
اي مش منظمة على شكل follicles ، منتشره فقط .
- No hurthle cells, no giant cells


NOTE
Cause Dysphagia and dyspnea

#Microscopic

#Diagnosis 👉🏻 Subacute Granulomatous thyroiditis ( Dequervain diseases)



#The_black_arrows
Gaint cell

#The_features
- Inflammatory infiltrate composed of multinucleated giant cells(enclose fragmentof colloid) , neutrophils, macrophage, lymphocytes, plasma cells
- Variable background of fibrosis
- a painful enlarged thyroid
- usually self-limited

#Gross  

#Diagnosis 👉🏻  Multinodular goiters (simple goiter)


#The_white_arrows
Colloid ( reddish brown )

#The_black_arrow
Fibrosis septa

#The_features
- Nodular enlargement
- Asymetrical
- Firm
- Show multinodular are variable in size and shape , and are separate by septa

NOTE
Cause Pressure symptoms due to compression of trachea and esophagus

#Gross  

#Diagnosis 👉🏻  Multinodular goiters


#The_white_area
Nodules

#The_black_arrow
Fibrosis Septa

#The_blue_stars
colloid

#The_yellow_arrows
Hemorrhage

#The_features
cut surface shows multinodular separated by fibrosis septa , hemorrhagic , brown colloid with focal calcification

#Microscopic

#Diagnosis 👉🏻  Multinodular goiters


#The_blue_arrows 
Colloid

#The_black_area
Fibrosis septa 
و Nodule هي يلي محوطه ب septa كامل

#The_features
- Multinodular are variable in size and shape , separate by septa
- The single nodule composed of multiple thyroid follicles that are Dilated by Colloid with flattened to hyperplastic epithelium cells

✓ The follicles are variable in size , separated by fibrous stroma

#Gross  

#Diagnosis 👉🏻  Colloid goiter -thyroid with colloid cysts-
( simple goiter/diffuse nontoxic goiter)


#The_white_arrow
Large colloid cyst

#The_black_arrow
Small colloid cyst

#The_features
Diffuse enlargement gland with brownish cysts, cut surface is brown (colloid)

#Microscopic

#Diagnosis 👉🏻 Colloid goiter ( simple goiter/diffuse nontoxic goiter)


#The_black_area
Follicle 

#The_features
The follicles enlarged and filled by abundant colloid , with Flattened follicular epithelial lining

#Microscopic

#Diagnosis 👉🏻 graves diseases


#The_black_area
 lymphoid follicle

#The_blue_arrows
papillary infoldings

#The_features
- Tall follicular cells (tall columnar epithelium cells) with papillae usually lacking fibrovascular cores
بسبب انه الخلايا حصل لها hyperplasia
- Nuclei are round, often basally located, rarely overlap
- Scalloping of colloid , or vacuoles due to follicular cells eat colloid for the production of hormones

#Gross

#Diagnosis 👉🏻 follicular thyroid neoplasm (follicular adenoma)


#The_white_arrow
Normal thyroid

#The_black_arrow
Capsule

#The_blue_star
Neoplasm (adenoma)

#The_features
- an encapsulated round
neoplasm with a uniform (solitary) nodule.
- bright brown appearance, surrounded by a rim of normal thyroid

NOTES
• Cause pressure symptoms
• Painless
• Cause hyperthyroidism

#Microscopic

#Diagnosis 👉🏻 follicular thyroid neoplasm


#The_black_arrow
Normal follicles

#The_red_area
Capsule

#The_white_arrow
Neoplasm (adenoma)

#The_features
- well differentiation
- an encapsulated round
neoplasm
- The tumor is composed of cloclosely packed follicles

#Gross

#Diagnosis 👉🏻  Papillary carcinoma


#The_blue_arrows
Normal thyroid

#The_black_arrows
Tumor tissue

#The_red_arrow
Calcification (Psammoma body)

#The_yellow_arrows
Tumor tissue
هنا عامله infiltrative

#The_features
- The tumor is usually solid
- grey white in color
- papillary projections
- sometimes it can be multifocal
- encapsulated or infiltrative
- calcification (appear white in color)

#Microscopic

#Diagnosis 👉🏻  Papillary carcinoma


#The_white_arrow
Psammoma body

#The_green_arrows
Optical clear nuclei ( ground glass nuclei)

#The_blue_arrows
Papillae

#The_black_arrows
Papillae by transfert section

#The_features
Nuclear features
- Change of nuclear size and shape
• nuclear enlargement, elongation
• Nuclear overlapping:  the nuclei are so crowded that they look like they are sitting on one another
• Ground glass nuclei : it means the chromatin is finely dispersed and optically clear. This appearance is also known as “Orphan Annie Eye” 
• groove nuclei are formed due to folding of  the unessential nuclear membrane
• nuclear inclusions
• Vascular Nuclei
- Nuclear membrane irregular

Other features
- randomly oriented papillae with fibrovascular cores
- Psammoma body in the fibrovascular cores

#Gross

#Diagnosis 👉🏻  Adrenocortical adenoma


#The_white_arrow
Adenoma

#The_features
- Circumscribed , Unilateral, solitary
- yellow tan in color
- Hemorrhage
- Functional adenoma may result in atrophy of contralateral adrenal cortex

NOTE
Cause hypertension and hypokalemia

#Microscopic

#Diagnosis 👉🏻  Adrenocortecal adenoma


#The_red_arrow
Adenoma

#The_black_star
Capsule of adenoma

#The_blue_arrow
Normal adrenal

#The_blue_star
Capsule of adrenal

#The_features
• adenoma cells are larger with different cytoplasm
• increased variation in nuclear size
• cells have abundant foamy cytoplasm like of zona fasciculata

#Microscopic

#Diagnosis 👉🏻   Adrenocortecal carcinoma


#The_black_star
Invasion (Metastases to vein)

#The_blue_arrow
Hemorrhage

#The_features
- Encapsulated tumor 
- Invasion of thick fibrous capsule
- Lymphovascular invasion
- hemorrhage
- hyperchromic nuclei

NOTES
Often are functional and can lead to
- Cushing diseas
- Masculinization in females
- Feminization in male

#Gross

#Diagnosis 👉🏻  Pheochromocytoma


#The_black_arrow
Small remnant of remaining adrenal

#The_white_star
adrenal neoplasm

#The_blue_arrow
Hemorrhage

#The_white_arrows
Cortex

#The_features
- Well circumscribed and unencapsulated
- Solid , gray tan
- hemorrhagic in cut surface

#Microscopic

#Diagnosis 👉🏻   Phenochromocytoma


#The_black_star
Neoplasm

#The_black_arrows
intervening capillaries

#The_blue_arrow
sustentacular cells

#The_red_area
Zellballen ( nest )

#The_yellow_arrows
Vacuoles

#The_blue_star
Normal adrenal


#The_features
- Nested (zellballen) with adjacent smaller sustentacular cells surrounded by abundant intervening capillaries
- Cells: large, polygonal to spindle , uniform or extensively vacuolated
- Cytoplasm: abundant fine, granular red-purple cytoplasm
- Nuclei: central round to oval, nucleoli prominent

#MICROSCOPIC

#Diagnosis 👉🏻 pilocytic astrocytoma
grade 1

#The_features
- bipolar cells (have processes extending form both ends
- mild hypercellularity
- hairy-like

#MICROSCOPIC

#Diagnosis 👉🏻 diffuse astrocytoma
grade 2


#The_red_arrow
mitosis

#The_features
- moderate hypercellularity
- mitosis
- little plemorphism
- fibillary (the hair-like processes are grouped to form the fibillary appearance)