Papilläres Schilddrüsenkarzinom- Häufiste Schilddrüsenkarzinom- Assoziiert mit RET/PTC Translokation and BRAF Mutationen (Onkogene), Exposition zu radioaktiven Strahlen während der Kindheit Histologie:- Wenig Protein, wenig DNA ...
Follikuläres Schilddrüsenkarzinom- 2. häufiste Form von Schilddrüsenkarzinom- Assoziiert mit ↓ Jod, RAS Aktivation, Deaktivation von PTEN- Hämatogene Metastasierung Histologie:- Trabekulärer Bau- Kapselinvasion, Invasion in Blutgefässen ...
Medulläres Schilddrüsenkarzinom- Von den parafollikulären C-Zellen abgeleitet, die meist im oberen Drittel der Schilddrüse lokalisiert sind- Produktion von Kalzitonin- Spontane Mutation in RET Onkogen (einzeln)- Hereditär: Familial ...
Anaplastisches Schilddrüsenkarzinom∼1-2% aller Schilddrüsenkarzinome- Am meisten aggressiv Histologie:- Hochgradige Zell- und Kernpolymorphie- Spindelzellig, pleomorphische Riesenzellen- Infiltrativ-destruktiv wachsend- Nekrosen und ...
Phäochromozytom- Aus den Chromaffinzellen- 25% hereditär: MEN2A, MEN2B, Neurofibromatose Typ 1, von Hippel Lindau (VHL) Histologie:- Pleomorphes Bild mit sehr grossen Zellen, Kernpolymorphie aber trotzdem benigne!- ...
Neuroendokrine Zellen- Können überall vorkommen, insbesondere aus dem Epithel des Gastointestinaltrakts oder Lunge - Bekommen Signal von Nervenzellen und sezernieren Hormone Mögliche Hormone:- Amine (Serotonin, Histamin)- ...
Karzinoides Karzinom- Entwirkeln meist im Gastrointestinaltrakt. Wird erst symptomatisch, wenn sich Lebermetastasen bilden und dem 1st Pass Metabolismus entgehen. Wenn Symptome vorhanden, dann heisse es Karzinoid Syndrom.Serotonin:- ...
Follicular adenomaMost common type of thyroid adenoma. Clinical features:- Often presents as a slow-growing solitary nodule- The nodule grows larger → develops autonomy → over the course of several years becomes a ...
Toxic adenomaPathophysiology: - Gain-of-function mutations of TSH receptor gene in a single precursor cell → autonomous functioning of the follicular cells of a single nodule → focal hyperplasia of thyroid follicular ...
Toxic multinodular goiter- Second most common cause of hyperthyroidism- More prevalent in iodine-deficient areas Pathophysiology: Chronic iodine deficiency/thyroid dysfunction → decreased hormone production → increased pituitary ...
Thyroid cystsClassification- Simple cysts are exclusively fluid-filled nodules lined by benign epithelial cells.- Complex cysts are partly solid and partly cystic and carry a 5-10% risk of malignancy. Etiology:∼ ...
Goiter - Differential- Iodine deficiency (leading cause of goiter worldwide) - Inflammation (eg, Hashimoto's thyroiditis, subacute granulomatous thyroiditis) - Graves' disease - Ingestion of goitrogens (eg, lithium carbonate) ...
Graves diseaseMost common cause of hyperthyroidism in the United States- F > M (8:1)- Typical age range: 20-40 years - 50% of patients with Graves disease have a family history of autoimmune disorders (eg, type 1 diabetes ...
Morbus Basedow1. Hyperplastisches Follikelepithel- Hohe zylindrische Zellen mit prominenten, vesikulärem Kern- Neigt sich dazu, sich papillär in das Lumen vorzuwölben 2. Wenig Kolloid 3. Gut vaskularisiertes Stroma ...
Riedel's thyroiditisRare, special form of autoimmune thyroiditis. Etiology:- Component of IgG4-related disease (may also cause fibrosis of salivary glands, kidneys, pancreas and lungs)IgG4 attacks thyroid follicar cells ...
Subacute granulomatous thyroiditis (De Quervain thyroiditis) ...Transient patchy inflammation of the thyroid gland that is associated with granuloma formation. Etiology:- Viral infections: Mumps virus, Coxsackie virus, influenza virus, echovirus, adenovirus- Mycobacterial ...
Hashimoto's thyroiditisMost common form of autoimmune thyroiditis and the leading cause of hypothyroidism in the United States.- F:M = 7:1 - Associations with HLA-DR3 and DR5, non-Hodgkin's lymphoma or autoimmune diseases ...
Hashimoto Thyreoiditis- Leicht fibrosiertes, knotiges mikrofollikuläres Schilddrüsenparenchym. - Dichtes lymphoplasmazelluläres Entzündungsinfiltrat mit Sekundärfollikeln. - Herdförmige entzündliche Zerstörung des ...
Papillary carcinomaMost common thyroid cancer. - Associated with RET/PTC rearrangements and BRAF mutations, childhood radiation. - Metastasizes to regional cervical lymph nodes.∼ 80% of cases- 30-50 years of age Pathology:- ...
Follicular carcinoma- Associated with PAX8-PPAR-γ rearrangement and RAS mutation.- Patients with iodine deficiency ∼10% of cases- 40-60 years of age - Hematogenous metastasis (lungs, bone) Pathology:- Uniform follicles- ...
Medullary thyroid cancerTissue of origin: Parafollicular cells (C cells) - Sometimes a genetic predisposition: multiple endocrine neoplasia type 2 (MEN2) (25% of medullary carcinomas)- Sporadic (75% of medullary carcinomas) ...
NeuroblastomaMalignant neuroendocrine tumor of the sympathetic nervous system that originates from neural crest cells.- 3rd most common childhood cancer overall, following leukemia and brain tumors- Mean age at diagnosis: ...
PheochromocytomaTumor arising from chromaffin cells, which are derived from the neural crest. Locations include:∼ 90% adrenal medulla (physiologically activated by acetylcholine) ∼ 10% extra-adrenal in the sympathetic ...
