《病理学》教学课件：12 内分泌系统疾病
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Diffuse hyperplasia in a patient with Grave’s disease.
Graves Disease
diffuse symmetric enlargement beefy deep red parenchyma
Graves Disease
Microscope: ▪ hyperplastic follicles lined by tall, columnar epith. ▪ crowded, enlarged epithelial cells --- small papillae ▪ the scalloped appearance of the edges of the colloid
Genetic factors
HLA-B8 HLA-DR3
Graves Disease Morphology Gross: thyroid gland---diffusely enlarged.
The cut surface of the thyroid has a fleshy appearance.
cortisol aldosterone
… insulin 胰岛素
…
thyroxine (T4) triiodothyronine
(T3) growth hormone
…
Excess Cushing syndrome hyperaldosteronism
原发性醛固酮增多症
hypoglycemia 低血糖
absorption of resorption of bone by osteoclasts calcium (skeletal system)
Thyroid diseases
Hyperthyroidism
Hypothyroidism
Mass lesions
Graves disease nontoxic goiter（simple goiter）
prepubertal children before epiphyses close
gigantism
Adults
acromegaly
soft tissues skin viscera bones of the face, hands and feet
Thyroid
hypothalamus-pituitary-thyroid axis
Thyroiditis
Neoplasms of thyroid
Graves Disease
In 1835, Robert Graves reported “violent and long continued palpitations in females” associated
with enlargement of the thyroid gland
islet of pancreas
胰岛
Testis 睾丸
Metabolic equilibrium /homeostasis
Classification
1. Diseases of under/over-production of hormones and their resultant biochemical and clinical consequences
TRH: thyrotropin-releasing hormone
TSH: thyroid-stimulating hormone
T4: thyroxine T3: triiodothyronine
The net effect of T4 T3 : basal metabolic rate
(BMR)
20 -40, women genetic factors
Graves Disease
Pathogenesis: autoimmune disorder
In serum, antibodies to TSH receptor
thyroid peroxisomes
thyroglobulin
Thyroid-stimulating immunoglobulin(TSI)
Thyroid
Baidu Nhomakorabea Follicles
• epithelium • thyroglobulin-rich colloid
Normal follicular cells
Synthesis and Storage of thyroid hormones
Function low normal
Epithelium flat cuboidal
Diseases of Endocrine System
Pathology Department, Basic Medical collage, Fudan University
thyroid 甲状腺
Adrenals
肾上腺
Ovary 卵巢
corpus pineal
松果体
Pituitary
垂体
Hormones
2. Diseases associated with the development of mass lesions.
morphologic findings hormone level
regulator metabolites
adrenal
islet of pancreas
thyroid
pituitary
Colloid
thick even
puberty, pregnancy, physiologic stress
Transient hyperplasia
high columnar
thin
Involution 复旧
Thyroid
parafollicular cells (“C” cells)
calcitonin
hyperthyroidism
甲亢
gigantism 巨人症 acromegaly
肢端肥大症
Insufficiency Addison disease
diabetes mellitus
糖尿病
hypothyroidism
甲减
cretinism 呆小病 dwarfism 侏儒症
Pituitary adenoma Growth Hormone
Release of H
Thyroid growth-stimulating immunoglobulin(TGI)
TSH-binding inhibitor immunoglobulins(TBIIs)
Follicular E. proliferation
Graves Disease
Pathogenesis: autoimmune disorder
Graves Disease
diffuse symmetric enlargement beefy deep red parenchyma
Graves Disease
Microscope: ▪ hyperplastic follicles lined by tall, columnar epith. ▪ crowded, enlarged epithelial cells --- small papillae ▪ the scalloped appearance of the edges of the colloid
Genetic factors
HLA-B8 HLA-DR3
Graves Disease Morphology Gross: thyroid gland---diffusely enlarged.
The cut surface of the thyroid has a fleshy appearance.
cortisol aldosterone
… insulin 胰岛素
…
thyroxine (T4) triiodothyronine
(T3) growth hormone
…
Excess Cushing syndrome hyperaldosteronism
原发性醛固酮增多症
hypoglycemia 低血糖
absorption of resorption of bone by osteoclasts calcium (skeletal system)
Thyroid diseases
Hyperthyroidism
Hypothyroidism
Mass lesions
Graves disease nontoxic goiter（simple goiter）
prepubertal children before epiphyses close
gigantism
Adults
acromegaly
soft tissues skin viscera bones of the face, hands and feet
Thyroid
hypothalamus-pituitary-thyroid axis
Thyroiditis
Neoplasms of thyroid
Graves Disease
In 1835, Robert Graves reported “violent and long continued palpitations in females” associated
with enlargement of the thyroid gland
islet of pancreas
胰岛
Testis 睾丸
Metabolic equilibrium /homeostasis
Classification
1. Diseases of under/over-production of hormones and their resultant biochemical and clinical consequences
TRH: thyrotropin-releasing hormone
TSH: thyroid-stimulating hormone
T4: thyroxine T3: triiodothyronine
The net effect of T4 T3 : basal metabolic rate
(BMR)
20 -40, women genetic factors
Graves Disease
Pathogenesis: autoimmune disorder
In serum, antibodies to TSH receptor
thyroid peroxisomes
thyroglobulin
Thyroid-stimulating immunoglobulin(TSI)
Thyroid
Baidu Nhomakorabea Follicles
• epithelium • thyroglobulin-rich colloid
Normal follicular cells
Synthesis and Storage of thyroid hormones
Function low normal
Epithelium flat cuboidal
Diseases of Endocrine System
Pathology Department, Basic Medical collage, Fudan University
thyroid 甲状腺
Adrenals
肾上腺
Ovary 卵巢
corpus pineal
松果体
Pituitary
垂体
Hormones
2. Diseases associated with the development of mass lesions.
morphologic findings hormone level
regulator metabolites
adrenal
islet of pancreas
thyroid
pituitary
Colloid
thick even
puberty, pregnancy, physiologic stress
Transient hyperplasia
high columnar
thin
Involution 复旧
Thyroid
parafollicular cells (“C” cells)
calcitonin
hyperthyroidism
甲亢
gigantism 巨人症 acromegaly
肢端肥大症
Insufficiency Addison disease
diabetes mellitus
糖尿病
hypothyroidism
甲减
cretinism 呆小病 dwarfism 侏儒症
Pituitary adenoma Growth Hormone
Release of H
Thyroid growth-stimulating immunoglobulin(TGI)
TSH-binding inhibitor immunoglobulins(TBIIs)
Follicular E. proliferation
Graves Disease
Pathogenesis: autoimmune disorder