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Thyroid gland - Coggle Diagram
Thyroid gland
Histology
Follicular cells
T3
T4
Parafollicular cells (C cells)
neuroendocrine cells
Calcitonin
Physiological hyperplasia + involution
Other thyroiditis
Riedel Thyroiditis
Extensive fibrosis
Incomplete capsule
Systemic autoimmune IgG4-related disease
Adhesive
Infectious thyroiditis
Indirect infection
Palpation thyroiditis
Hypothyroidism
Causes
Primary
Genetic defects
PAX8
FOXE1
Postablative Sx
Iodine sufficient area
Hashimoto thyroiditis
Onset
45-65 y/o
F:M = 20:1
Autoimmune
Self-tolerance breakdown
Type
Cytotoxic T cell mediated cell death
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Cytokine mediated cell death
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Antibody-dependent cell-mediated cytotoxicity(ADCC)
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Morphology
Diffuse enlargement
Vague nodule
Fibrous capsule
Micro
Extensive mononuclear inflammatory infiltrate
Lymphocyte
Hurthle cell change
Oncocytic cytoplasm
Eosinophilicgranule
Clinical
Painless
Transient thyrotoxicosis
Increased Risk
Marginal zone lymphoma
SLE
Sjogren
Papillary carcinoma
Iodine deficiency area
Congenital hypothyroidism
Radiation
Secondary
Onset
Infant / child
Cretinism
causes
Iodine deficiency
Inborn errors
Clinical
Impaired CNS
Mental retardation
Skeleton
Short stature
Umbilical hernia
Protruding tongue
Adult / older child
Myxedema
Causes
Accumulation
GAGs
Hyaluronic acid
Clinical
Mental sluggishness
Slowing of mental and physical activity
Non-pitting
Origin
Pharyngeal epithelium
Thyrotoxicosis
Causes
Granulomatous(de Quervain) thyroiditis
Onset
40-50 y/o
F:M = 4:1
After URI
Clinical
Radiating pain
Self-limited (6-8w)
Morphology
Complete capsule
Stages
Later
Colloid / granuloma
Regenerative
Chronic inflammatory/ fibrosis
Active
Microabscess
Subacute lymphocytic thyroiditis
Onset
Middle age
Female > M
5% Postpartum
Micro
w/o Hurthle cell change
Clinical
one-third become hypothyroidism
Painlless
Transient hyperthyroidism
Struma ovarii
Ovary teratoma
Hyperthyroidism
Secondary
Rare
Primary
Diffuse hyperplasia(Graves disease)
Onset
20-40 y/o
F:M = 10:1
Clinical triad
Infiltrative ophthalmopathy
Pretibial myxedema
Hyperthyroidism
Autoimmune disorder
GAG deposit
Morphology
Diffuse hypertrophy
Hyperplasia of follicles
W/o nodule
Micro
Crowded tall follicular cells
W/o fibrovascular core
Papillary infold
Pale colloid with scalloped margins
scalloped margins
Extrathyroid tissue
Hyperfunctioning multinodular goiter/adenoma
Iodine-induced
Clinical manifestation
Cardiac
Tachycardia
Arrhythmia
Cardiomegaly
CHF
LV dysfunction
Palpitation
Neuromuscular
Moody
Tremor
Ocular
SNS overactive
upper eye lip constriction
Wide staring gaze (Large eye)
Lag sign
Proptosis
Specific for Graves disease
GI
D+
Osteoporosis
Skin
Warm
Soft
Flushed
Thyroid storm
Heavy fever
Atrial fibrillation
Apathetic hyperthyroidism
old people
Hypothalamus-pituitary-thyroid axis