21 Conception: Goiter is a group of diseases of thyroid hyperplasia, enlargement due to iodine deficiency or other factors. According to hyperthyroidism or not, goiter can be divided into nontoxic goiter and toxic goiter.
25 Conception Nontoxic goiter due to iodine deficiency to reduce thyroid hormone secretion, thyroid stimulating hormone (TSH) hypersecretion, follicular epithelial hyperplasia, follicular goiter glial accumulation. No hyperthyroidism, so also called simple goiter.
26 Type nontoxic goiter local distributed
27 The thyroid gland has a bi-lobe connected by a narrow isthmus.
65 Conception Thyroid adenoma is a common benign tumor in the thyroid caused by thyroid follicular epithelium. young and middle-aged female common involved, slow- growthing, no overt symptom, 1% hyperthyroidism.
66 Pathological feature
67 Gross : single, round or oval, millimeters to 3-5cm, firmly, smooth and glossy of the surface, perfect membrane, cystis degeneration, fibrosis, calcification in the tumor centre
68 Here is a surgical excision of a small mass from the thyroid gland that has been cut in half. The mass is well-circumscribed. Grossly it felt firm. This is a follicular adenoma.
69 Here is another follicular neoplasm (a follicular adenoma histologically) that is surrounded by a thin white capsule. It is sometimes difficult to tell a well-differentiated follicular carcinoma from a follicular adenoma.
72 Simple adenoma The red arrow is located within the adenoma. Although composed of follicular cells, little colloid is seen. The blue arrow points to the capsule of the adenoma, a few strands of connective tissue. The yellow arrow points to colloid within a large normal follicle
73 Simple adenoma
74 Colloid adenoma
75 Fetal adenoma
76 Embryonal adenoma
77 Distinguish nodular goiter adenoma Number poly-nodus single membrane No complete membrane Size of Follicle larger complete membrane Smaller Periphery No effect Effect tissue Change + _
78 Thyroid cancer
80 Pathological feature
81 Papillary adenocarcinoma General : 40%--60%, young female, low potential malignancy, slow-moving, five year survival rate 75%. Characteristic : mamillae, invasing vessel, capsul Primal complaint : surrounding lymphatic metastasis
82 The thyroid is massively distorted by a multinodular growth. Shaggy external surface due to difficulty in dissecting organ from other structures, a feature which suggests malignancy.
83 The dark reddish brown tissue is characteristic of normal thyroid. The large tan nodules represent carcinoma. No large areas of hemorrhage and necrosis are seen.
84 Sectioning through a lobe of excised thyroid gland reveals papillary carcinoma.
85 This is the microscopic appearance of a papillary carcinoma of the thyroid. The fronds of tissue have thin fibrovascular cores. The fronds have an overal papillary pattern.
86 The center is fibrovascular; the cells covering it are epithelial.
87 This closeup shows that the cells range from low columnar to columnar. The red arrow shows a cell with an Orphan Annie eye nucleus.
90 Follicular adenocarcinoma General : 10%--15%, middle-aged female, low potential malignancy, slow-moving, five year survival rate 30%--40%. Characteristic : follicle structure Infiltration : capsul and blood vessel.
91 2.9cm minimally invasive follicular carcinoma of the thyroid
95 At the center and to the right is a medullary carcinoma of thyroid. At the far right is pink hyaline material with the appearance of amyloid. These neoplasms are derived from the thyroid "C" cells and, therefore, have neuroendocrine features such as secretion of calcitonin.
98 Undifferentiated carcinoma General: 15%, height-malignant, quick growth, infiltration and metastasis to surrounding tissues at early Type: small-cell carcinoma, giant cell carcinoma, spindle cell carcinoma, mixed cell carcinoma
99 Disease of Pancreatic Island
100 Type of cells A cell: 15-25%,secreting Glucagon B cell: 60-70%, secreting Insulin D cell: 5-10%, secreting Somatostatin PP cell: 2%, secreting pancreatic polypeptide G cell: secreting gastrin
101 Pancreatic island A cell B cell D cell
102 Diabetes mellitus
103 Reasons : Conception Deficient Insulin relatively or absolutely, Target cells low-sensitivity to Insulin, Defect structure of Insulin Result : a chronic disease involving the metabolic disorder of carbohydrate, fat, protein Major characteristic: hyperglycosemia, glucosuria; polydipsia, polyphagia, diuresis, weight loss -- 三多一少