۞ The problems in the thyroid gland is inflammation

𑁍 The types of inflammation
- Acute ➪is rare , show in the supportive
- Subacute ➪ dequervain
- Chronic ➪ Hashimoto ( autoimmune diseases) and riedel ( idiopathic)

#Gross  

#Diagnosis 👉🏻  Hashimoto


#The_features
- Symmetrical Enlargement ( both sides are the same size )
- Firm , painless
- tannish yellow color or ( pale to grayish )

#Common_in
Female more than male , usually 45 - 65 years old

NOTES
• Most common cause of hypothyroidism
• hyperthyroidism may be seen early but is transient
• Not cause Dysphagia or dyspnea
• May develop into papillary thyroid carcinoma or Extranodal marginal zone lymphoma

#Gross  

#Diagnosis 👉🏻  Hashimoto ( atrophic gland )


✓ الغدة تضمر بسبب destruction يلي يحدث لفتره طويل
✓ تكون كلا الجهتين متساوية في الحجم

#Microscopic

#Diagnosis 👉🏻  Hashimoto


#The_white_arrows
Lymphoid follicules

#The_black_arrow
Germinal center

#The_features
Extensive lymphocytic infiltrate, that accumulation in Follicles with germinal centers , appears in dark blue color

#Microscopic 

#Diagnosis 👉🏻  Hashimoto


#The_green_arrow
Lymphoid follicles

#The_black_arrow
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 👉🏻  Hashimoto


#The_blue_arrow
Lymphoid follicular

#The_black_areas
Hurthle cell

#The_green_arrows
Lymphocytic infiltrate

#The_yellow_arrows
Colloid

#Microscopic 

#Diagnosis 👉🏻  Riedel thyroiditis


#The_black_arrows
Dense fibrosis

#The_blue_arrows
Chronic inflammatory cell infiltrate

#The_yellow_arrow
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

#Microscopic

#Diagnosis 👉🏻 Subacute Granulomatous thyroiditis ( Dequervain diseases)


#The_black_area
Gaint cell 

#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

#Microscopic

#Diagnosis 👉🏻  Multinodular goiters


#The_white_area
Follicles

#The_black_area
Fibrosis septa 

#The_blue_arrows
Hemorrhage

#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

#Gross

#Diagnosis 👉🏻 Graves diseases

#The_features
IN CUT SECTION
- Diffuse enlarged
- symmetrically
- lobulated
- beefy red (lighter) in color

#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

#Microscopic

#Diagnosis 👉🏻 graves diseases


#The_black_area
 lymphoid follicle

#The_blue_arrows
papillary infoldings

#The_brown_arrows
follicular cells appear columnar

#The_yellow_arrows
Scalloping or vacuoles

#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