Вы находитесь на странице: 1из 36

Histopathology of Endocrine System

by Dr. Irene Suryahudaya Pathologist-dermatologist

Endocrine system
Primary function : control of HOMEOSTASIS Endocrine disease ---- result from pathogenetic mechanism----incl abnormality :in the synthesis and secretion of hormonal stimulation. Homeostasis ??-------------

In general; endocrine disorder


Production of hormone :
Underproduction Overproduction
Hyperfungtional state

Clinical apearance
Hypofungtional

PITUITARY GLAND
Embryology and anatomy of pituitary gland

Diseases of pituitary gland


Hyperpituitarism. Increased production. And release hormones. Gen: Cause by adenoma of the anterior pituitary. Microscopic:monomorph adenoma ,in rutine section HE can app as eosinophilic,basophilic or chromophobic appearance. Hypopytuitarism. May result fr hypothalamic /primary pitutari disorder. Lesion as craniopharyngioma or,glioma. Primary pit disorders underline most cases ; causes include a; Non secretory adenomas,sheehans syndrome,empty sella syndrome. Radiation and accident.
6

Non secretory pituitary adenomas


Present as space occupying lesions Grossly indistinguishable fr fungtional adenomas Microscopic: App is variable,incl some poorly granulated,chromophobic adenomas

Sheehanss yndrome
Usually causes by infarction of the anterior pituitary Ass: with obtetrichemorrhage/shock It may also occur in male ?and non pregnant woman ? (trauma, vascular accident, DIC, sickle cell anemia) Gen ass with destruction of 90 to 95 % of the gland

Empty sella syndrome


Primary lessions : herniation of arachnoid and CSF through a defect in the diafragma sellae,----result compression of the pituitary Secondary lesions following destruction of normal gland via ischemic injury,infarction of adenoma or radiation Enlargement of the sella may be mistaken radiolographically for a pituitary neoplasm

Craniopharyngioma
5% of intracranial neoplasm Most are found in patients during 2-3 decades Characteristic: cystic ,calsification 75% Microscopically: composed of a mixture of squamous apithelial elements and delicate reticular stroma Appearance of the enamel organ of a developing tooth Gliosis is common at the perifer Malignancy is rare
10

THYROID GLAND
Embryologi and anatomi

11

12

13

Diseases of thyroid gland


Congenital lesions
Hyperthyroidism hypothyroidism

Thyroiditis
Goiter Neoplasm

14

Congenital lesions
Thyroglossal duct cysts Represent persistence of thyroid anlage extending from the foramen cecum Midline cysts anterior to the trachea Histopatologic : varying mixtures of squqmous and columnar epithelialand lymphoid cells May become secondary infection

15

Hyperthyroidism
A hypermetabolic state secondary to increased levelsof circulating T3 andt4 Clinical : nervousness,heat intolerance excessive perspiration, fatigue, palpitation, tachycardi, weight loss despite good appetite.Wide-eyed Laboratory:elevated T3 and T4 Thyroid storm

16

Hypothyroidism
A hypometabolic state caused by deficiency of thyroid hormones Clinic: Cretinism if thyroid defisiency develops during perinatal period or infancy,and myxedema in older chidren and adults

17

Thyroiditis
Infectious thyroiditis Hashimotos Thyroiditis Subacute granulomatous thyroiditis Lymphocytic thyroiditis Riedel thyroiditis

18

Infectious thyroiditis
Agents: staphylococus aureus,streptococci,salmonella,enter obacter,mycobacteria and fungi May be hematogenous or associated with local trauma RRR

19

Hashimoto thyroiditis
Autoimun disorder Female predominance(10:1) Peak incidence is 30 to50 years of age Associated with HLA-DR5 and other autoimun disorders eg: SLE Clinical:symmetric or focal rubbery enlargementof the gland with an intake capsule Microscopic:exuberant lympocytic infiltrate with germinal centers.
20

Subacute granulomatous thyroiditis


De QuervainS Thyroiditis An inflamatory disorder of uncertain etiology;viral origin is sugested Female predominance Clinical : fever,painfull enlargement of the gland ,trancient T3-T4are elevated Micoscopic:enlargement of the gland,evokes neutophilic infiltrates,macrophagesand multinucleated giant cells
21

Subacute lymphocyticthyroiditis
An inflamatory disorder of unknown etiology defined histologically by nonspesific lymphoid infiltrationof the thyroid parenchyma No germinal center formation No significantplasma cell infiltrate No clear with viral infection

22

Riedels thyroiditis (struma)


An uncommon fibrosing process of unknown etiology Replacement of thyroid parenchyma by dense fibrous tissue penetrating the capsule and extending into contiguous neck structures Female predominance(3:1) Peak incidence fourth to seventh decades

23

Diffuse nontoxic goiter(simple goiter)


The gland is diffusely enlarged No evidence of hyper or hypothyroidism Occurs in endemic and sporadic forms Endemic goiter is most prevalent in areas with dietary iodine deficiency e.g;Alps,himalaya) Sporadic goiter is less common than endemic goiter Female predominance(8:1) Peak incidence in puberty/young adult life Mic: The gland is modestly enlarged,hyperemic,hypertrophyand 24 hyperplasia of follicular epithelium

Neoplasms
Adenomas Multiple histologic all representing follicular neoplasms Mic: fibrous capsule Architecture distinct from the ajacent gland Abcence of multinodularity in the remaining gland Carcinomas Female predominance Causes 7000 U.S deaths annually Morphologic variants: Papillary.follicular,med ullary,others(sarcoma, lymphomas)

25

26

27

28

Papillary carcinoma
Most common form of thyroid cancer in children & adults All thyroid neoplasms with papillary architecture Typically infiltratif;fibrosis and calcification are common,often multifocal Clearground-glassnuclei are common and diagnostic of papillary carcinoma Psamomas bodies are found in papillaein one half of patients
29

Follicular carcinoma
One fourth of thyroid malignancies Peak incidence in the fith to sixth decades Gross resembling follicular adenoma.fibrosis,hemorhage,necrosis and cyst formation are relatively common Ground glass nuclei and psamomas bodies are absent Clinical features,more aggressive than papillary ca
30

Medllary carcinoma
Rare tumor Arising from calcitonin producing cells of the thyroid Blood calcitonin is high

31

Parathyroid glands
Hyperfunction : a. primary---due to hyperplasia b.Secondary---reaction to hypocalcemia Hypoparathyroidsm accidental surgical removal of the parathyroid during thyroidectomi autoimun disease conggenital defisiency

32

Adrenal cortex
Developmental anomalies Hypofunction of adrenal cortex (hypoadrenalism) Hyperfungtion of adrenal cortex Hyperadrenalism Cushings disease

33

Hypofungtion of adrenal cortex


Cused by anatomic ormetaboliclesions in the adrenal cortex(primaryadrenocortical insuffisiency) Caused by hypothalamicpituitary disease (secondary)

34

Cushings syndrome
Pheochromocytoma

35

Thymus
Thymic agenesis and hypoplasia Thymic hyperplasia tumors

36

Вам также может понравиться