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DISEASESOFTHYROID
GOITERGoiterisdefinedasenlargementofthethyroidgland.
DIFFUSENONTOXICGOITERClassification:①Endemic:goiterarepresentmorethan10%ofthepopulation.②Sporadic:morecommoninfemales,pubertyoryoungadult.
临床病理联系
Etiologyandpathogenesis（1）Deficientiodineintake?TRH?,TSH?（2）Dietaryofgoitrogens→interferewiththyoidhormonesynthesis:Calcium,fluorideslithiumandthiocyanates;vegetables:cabbage,turnip,cauliflower,cassava
（3）Hereditarybiosyntheticdefectofthyroidhormone
Inmostcases,thecauseofsporadicgoiterisnotaparent.
Morphology:
itischaracterizedbychangesofhypertrophy,hyperplasiaandinvolutionofthyroidfollicularcells.Firmanddiffusesymmetricalenlargement,oftenwithnormalthyroidhormoneoutput.Thecutsurfaceispale,brown-gray,glisteningandgelatinous.
Threestages:①follicularproliferation：diffuseproliferationoffollicularepithelialcell,theepithelialcellsmaybecuboidal,tallcolumnar.grossly:Diffusesymmetricalenlargementofthyroid.
②colloidgoiter:epithelialcellsbecomeflattened,thefolliclesareenlargedandfilledwithcolloid.Grossly:Thecutsurfaceisbrown,glassyandtranslucent.
③nodulargoiter:theglandisdeformedbymultiplecolloidnodulesofallsizes,someofwhicharefilledwithcolloid.
CLINICOPATHOLOGICASSOCIATIONSymptomsrelatedtopressureonadjacentstructure.
DIFFUSETOXICGOITERGraves’diseaseorBasedow’sdiseasealsocalledexophthalmicgoiterDefinition:adiseasecharacterizedbyhyperplasiaofthyroidfollicularcellsandhyperthyroidism.Somepatienthaveexophthalmos.
Hyperthyroidism(thyrotoxicosis)___Thehypermetabolicstateinducedbyhyperfunctionofthethyroidwhichwascausedbytheoversupplyofactivethyroidhormone.
EIOLOGYANDPAHOGENESISAutoimmunedisease:anti-TSHreceptorantibody:TSI,TGIHeredity
MORPHOLOGYGrossly:usuallydiffuselyandsymmetricallyenlargedwithameaty,red-b
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