Thyroid: Grave's disease

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A 42 yr old female.  Signs and symptoms of hyperthyroidism, who failed conservative management.  Surgical intervention revealed a diffusely enlarged gland, no nodularity.

1.    Why is this section abnormal?  Describe the abnormal histological features.

The gland is diffusely enlarged (symmetrical)

Hyperplastic acinar cells are tall, columnar and have large nuclei reflecting a high degree fo metabolic activity

Crowding of acinar cells produce papillary structures which protrude into the lumen

Colloid appears scalloped due to active thyroxine secretion

2.    T/F.  The histological hallmark of this disease is:

Inflammation F

Hyperplasia T

Neoplasia F

None of the above F

The pathogenesis of this disease is supposed to be:

      Infective F

      Autoimmune with IgA against TRH receptor F

      Drug-related F

      Autoimmune with IgG against TSH receptor T

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Copyright � Joseph Ong 2003