Term
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Definition
| Thyroid Stimulating Hormone |
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Term
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Definition
| Dissociated of thyroid from TSH control |
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Term
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Definition
| inhibits oxidation of iodide blocking production of thyroid hormones. Also inhibits peripheral deiodination |
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Term
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Definition
| Also C cells, secrete calcitonin |
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Term
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Definition
| sympathetic nerve hyperactivity, increased BMR, soft and flushed skin, heat intolerance, increased cardiac output, tachycardia, atrial fibrillation, lowoutput heart failure. |
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Term
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Definition
| Severe acute hyperthyroidism. |
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Term
| Apathetic Hyperthyroidism |
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Definition
| Elderly with confounding comorbidities. Low TSH, high T4. |
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Term
| Thyroid Radioactive Iodine Uptake |
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Definition
| Whole gland: Grave's/hyperplasia, solitary nodule: adenoma, decreased uptake: thyroiditis |
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Term
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Definition
| inborn error of thyroid metabolism. Either: iodide transport, iodide organification, or iodotyrosine coupling is broken. TPO deficiency is most common. |
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Term
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Definition
| Deficiency is most common cause of dyshormonogenetic goiter |
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Term
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Definition
| hypothyroidism secondary to dyshormonogenetic goiter with sensorineural deafness. SLC26A4 gene deficiency. |
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Term
| Thyroid hormone resistance syndrome |
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Definition
| autosomal-dominant disorder. Mutated thyroid hormone receptor. Hypothyroidism with high T4 and TSH |
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Term
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Definition
| anti-microsomal, anti-thyroid peroxidase and anti-thyroglobulin. goiter |
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Term
| Central (Secondary) Hypothyroidism |
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Definition
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Term
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Definition
| hypothyroidism in infancy causes mental retardation, impaired development, umbilical hernia |
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Term
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Definition
| Also Gull disease. Hypothyroidism after childhood. lethargy, confusion, fatigue, apathy, slowed intellect, constipation, atherosclerosis, broad/coarse facial features, hypothyroidism. |
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Term
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Definition
| Most common cause of hypothyroidism. Gradual thyroid failure and often thrombocytopenia, 45-65, more common in women. CTLA4 is negative regulator of T-cell responses and PTPN22 for protein tyrosine phosphatase-22. Hurthle cells |
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Term
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Definition
| abundant eosinophilic granular cytoplasm cells seen in Hashimoto's thyroditis |
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Term
| Fibrous Variant of Hashimoto's |
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Definition
| severe thryoid follicular atrophy and dense keloid-like fibrosis of acellular collagen. Doesn't extend beyond capsule. |
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Term
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Definition
| 40-50, women, triggered by viral infection. Unilateral or bilateral thyromegaly. Microabscesses, Multinucleate giant cells. painful thyroid, transient hypothyroidism. radioactive iodine uptake is diminished |
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Term
| Painless (Subacute Lymphocytic) Thyroiditis |
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Definition
| mild hypothyroidism, middle-aged women, pospartum in 5%. Lymphocytic infiltration, painless goiter, hyperthyroidism. One year later 1/3 are hypothyroid. |
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Term
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Definition
| unknown etiology, extensive fibrosis continuous with neck structures. Hard fixed thyroid. Associated with other idiopathic fibroses |
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Term
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Definition
| Most common cause of endogenous hypoerthyroidism. Triad: Hyperthyroidism, ophthalmopathy with exophthalmos, dermopathy called pretibial myxedema. Women. Thyroid auto-antigens often to TSH receptor, thyroid-stimulating immunoglobulin, thyroid growth-stimulating immunoglobulins, TSH-binding inhibitor immunoglobulins. diffuse thyroid hypertrophy, lack fibrovascular cores, scalloped margins, germinal centers. Treated with iodine, beta-blockers and surgery. |
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Term
| Thyroid-stimulating immunoglobulin in Grave's |
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Definition
| mimics TSH, targeted against TSH. Most all Grave's |
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Term
| Thyroid growth-stimulating immunoglobulins in Grave's |
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Definition
| Against TSH receptor but focused on proliferation |
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Term
| TSH-binding inhibitor immunoglobulin in Grave's |
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Definition
| Prevent TSH from binding. May inhibit thyroid cell function |
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Term
| Diffuse Nontoxic (Simple) Goiter |
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Definition
| also colloid goiter. enlargement iwthout nodularity. Endemic when due to low iodine. Goitrogens can cause, especially thiocyanate. Stages of hypoplasia and colloid involution. Columnar cells in follicles. |
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Term
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Definition
| caused by recurrent hyperplasia and involution. mistaken for neoplasia. Nodules may experience autonomous growth. asymmetrical, Can cause mass effects or hyperthyroidism. Uneven radioactive iodine uptake w/ hot nodules. |
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Term
| Plunging or intrathoracic goiter |
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Definition
| Goiter that grows behind the sterum and clavicles into the thorax |
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Term
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Definition
| Multinodular goiter with autonomous nodule causing hyperthyroidism without exophlamos. |
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Term
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Definition
| 1 in ten are malignant. Solitary nodules, younger patients, males more likely neoplastic when found, hot nodules are mote likely benign |
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Term
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Definition
| Follicular adenomas. Majority are non-functional and are cold. Encapsulated unlike carcinoma, demarcated from parencyma, hemorrhage, calcification, cysts. Genes: TSHR, TAS, PIK2CA, GNAS |
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Term
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Definition
| uncommon. female. Includes Papillary, follicular, anaplastic, medullary (only non-follicular). Follicular tumors genes: MAP and PI-3K/AKT |
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Term
| Papillary Thyroid Carinoma Genetics |
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Definition
| MAP. Either RET or NTRK1 mechanism or BRAF activating mutation. RET/PTC fusion protein in radiation. These genetic changes are not shared with any other thyroid carcinoma |
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Term
| Follicular Thyroid Carcinoma Genetics |
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Definition
| PI-3K/AKT in slightly less than half including RAS/PIK2CA gain and PTEN loss-of-function. Unique PAX8/PPARG fusion by (2;3)(q13;p25). |
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Term
| Anaplastic (Undifferentiated) Thyroid Carcinoma Genetics |
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Definition
| Dedifferentiation from another form. Worsened by p53 or beta-catenin mutations |
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Term
| Medullary Thyroid Carcinoma Genetics |
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Definition
| MEN-2 associated. No chromosomal rearrangements. |
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Term
| Papillary Carcinoma Morphology |
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Definition
| Most common, 25-50, papillary foci, ground-glass or Orphan Annie eye nuclei or pseudo-inclusions. Psammoma bodies. lymphatic invasion. Good prognosis, hoarsness etc are advanced disease. Cold masses. |
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Term
| Follicular variant of Papillary Thyroid Carcinoma |
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Definition
| More often RAS or BRAF. More often encapsulated |
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Term
| Tall-cell variant of papillary thyroid carcinoma |
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Definition
| tall columnar cells in older individuals. BRAF in most and often RET/PTC translocation. Aggressive |
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Term
| Diffuse Sclerosing variant papillary thyroid carcinoma |
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Definition
| younger. papillary growth pattern with nests of squamous metaplasia. Lymphocytic infiltrate. Lymph node metastases. Lack BRAF but RET/PTC is in half. |
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Term
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Definition
| women 40-60 w/ deficiency iodine, degenerative changes, uniform cells with colloid containing follicles. NO PSAMMOMA BODIES. Solid/trabecular growth signals lymphatic infiltration. Hematogenous spread is common. 50% in 10 years |
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Term
| Oncocytic variant of follicular thyroid carcinoma |
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Definition
| Also Hurthle cell. Cells have abundant granular, eosinophilic cytplasm |
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Term
| Anaplastic (Undifferentiated) Thyroid Carcinoma |
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Definition
| Very high mortality rate. highly anaplastic cells including: pleomorphic giant cells, spindle cells, mixed spindle and giant cells, cytokeratin but not thyroglobulin. rapidly enlarging bulky neck mass. No effective therapies |
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Term
| Anaplastic (Undifferentiated) Thyroid Carcinoma |
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Definition
| Very high mortality rate. highly anaplastic cells including: pleomorphic giant cells, spindle cells, mixed spindle and giant cells, cytokeratin but not thyroglobulin. rapidly enlarging bulky neck mass. No effective therapies |
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Term
| Anaplastic (Undifferentiated) Thyroid Carcinoma |
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Definition
| Very high mortality rate. highly anaplastic cells including: pleomorphic giant cells, spindle cells, mixed spindle and giant cells, cytokeratin but not thyroglobulin. rapidly enlarging bulky neck mass. No effective therapies |
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Term
| Medullary Thyroid Carcinoma |
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Definition
| Neuroendocrine neoplasm from parafollicular cells. Secrete calcitonin and potentially serotonin, ACTH, VIP. Associated with MEN-2A/B. Often bilateral/multicentric. Necrosis and hemorrhage, polygonal/spindle-shaped cells. Nest, amyloid deposits and calcitonin. Multicentric C-cell hyperplasia in the surrounding parenchyma. Carcinoembryonic antigen. |
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