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DIFFUSE AND MULTINODULAR GOITER (Basic Pathology)

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Naseem Saeed

Diffuse and multinodular goiters are enlargements of the thyroid gland that result from impaired thyroid hormone synthesis. This impairment leads to a compensatory rise in TSH, causing hypertrophy and hyperplasia of thyroid follicular cells and gross enlargement of the thyroid. There are two main types: endemic goiter, which occurs in iodine-deficient areas; and sporadic goiter, which is more common in females and has various potential causes. Morphologically, diffuse goiter causes initial symmetric enlargement while multinodular goiter features irregular nodules over time. Clinical features include mass effects on surrounding structures and potential development of a hyperfunctioning nodule.

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DIFFUSE AND MULTINODULAR GOITER (Basic Pathology)

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Naseem Saeed
13 views2 pages
Diffuse and multinodular goiters are enlargements of the thyroid gland that result from impaired thyroid hormone synthesis. This impairment leads to a compensatory rise in TSH, causing hypertrophy and hyperplasia of thyroid follicular cells and gross enlargement of the thyroid. There are two main types: endemic goiter, which occurs in iodine-deficient areas; and sporadic goiter, which is more common in females and has various potential causes. Morphologically, diffuse goiter causes initial symmetric enlargement while multinodular goiter features irregular nodules over time. Clinical features include mass effects on surrounding structures and potential development of a hyperfunctioning nodule.

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DIFFUSE AND MULTINODULAR GOITER(basic pathology)

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Diffuse and multinodular goiters are enlargements of the thyroid gland that result from impaired thyroid hormone synthesis. This impairment leads to a compensatory rise in TSH, causing hypertrophy and hyperplasia of thyroid follicular cells and gross enlargement of the thyroid. There are two main types: endemic goiter, which occurs in iodine-deficient areas; and sporadic goiter, which is more common in females and has various potential causes. Morphologically, diffuse goiter causes initial symmetric enlargement while multinodular goiter features irregular nodules over time. Clinical features include mass effects on surrounding structures and potential development of a hyperfunctioning nodule.

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13 views2 pages

DIFFUSE AND MULTINODULAR GOITER (Basic Pathology)

Uploaded by

Naseem Saeed
Diffuse and multinodular goiters are enlargements of the thyroid gland that result from impaired thyroid hormone synthesis. This impairment leads to a compensatory rise in TSH, causing hypertrophy and hyperplasia of thyroid follicular cells and gross enlargement of the thyroid. There are two main types: endemic goiter, which occurs in iodine-deficient areas; and sporadic goiter, which is more common in females and has various potential causes. Morphologically, diffuse goiter causes initial symmetric enlargement while multinodular goiter features irregular nodules over time. Clinical features include mass effects on surrounding structures and potential development of a hyperfunctioning nodule.

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DIFFUSE AND MULTINODULAR GOITER

|--- Introduction
| |--- Enlargement of the thyroid, most common manifestation of thyroid disease
| |--- Diffuse and multinodular goiters reflect impaired synthesis of thyroid hormone
| |--- Impaired synthesis leads to compensatory rise in serum TSH
| |--- Causes hypertrophy and hyperplasia of thyroid follicular cells
| |--- Gross enlargement of the thyroid gland
| |--- Degree of enlargement proportional to level and duration of hormone deficiency
|
|--- Types of Goiters
| |--- Endemic Goiter
| | |--- Occurs in geographic areas with low iodine content in soil, water, and food
| | |--- Present in more than 10% of the population in a given region
| | |--- Common in mountainous areas (Himalayas, Andes)
| | |--- Declined significantly with dietary iodine supplementation
| |--- Sporadic Goiter
| | |--- Less common than endemic goiter
| | |--- More common in females, peak incidence in puberty or young adulthood
| | |--- Causes:
| | | |--- Substances interfering with thyroid hormone synthesis (e.g., excessive calcium,
certain vegetables)
| | | |--- Hereditary enzymatic defects (dyshormonogenetic goiter)
| | | |--- Often unknown cause
|
|--- Morphology
| |--- Diffuse Goiter
| | |--- TSH-induced hypertrophy and hyperplasia of thyroid follicular cells
| | |--- Initial diffuse, symmetric enlargement of the gland
| | |--- Follicles lined by crowded columnar cells
| | |--- May form projections similar to Graves disease
| |--- Colloid Goiter
| | |--- If dietary iodine increases or hormone demands decrease
| | |--- Stimulated follicular epithelium involution to form an enlarged, colloid-rich gland
| | |--- Cut surface: brown, glassy-appearing, and translucent
| | |--- Follicular epithelium may be hyperplastic or flattened and cuboidal
| | |--- Colloid abundant during involution periods
| |--- Multinodular Goiter
| | |--- Recurrent episodes of hyperplasia and involution
| | |--- Irregular enlargement of the thyroid
| | |--- Conversion of long-standing diffuse goiters into multinodular goiters
| | |--- Multilobulate, asymmetrically enlarged glands
| | |--- Irregular nodules with variable amounts of brown, gelatinous colloid
| | |--- Older lesions show fibrosis, hemorrhage, calcification, and cystic change
| | |--- Microscopic appearance: colloid-rich follicles and areas of hypertrophy and
hyperplasia
|
|--- Clinical Features
| |--- Mass effects of enlarged gland
| | |--- Cosmetic problem of a large neck mass
| | |--- Airway obstruction
| | |--- Dysphagia
| | |--- Compression of large vessels (superior vena cava syndrome)
| |--- Hyperfunctioning (toxic) nodule may develop

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