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Pathology - Graves' disease
Definition: An autoimmune thyroid disorder marked by thyrotoxicosis and widespread hyperplasia of the thyroid gland.
Epidemiology • Prevalent, impacting up to 1% of the population. • The highest frequency occurs in young adults aged 30 to 40. • Women are disproportionately impacted compared to men.
Aetiology • Synthesis of antibodies that stimulate the TSH receptor. Pathogenesis TSH receptor-stimulating antibodies attach to the TSH receptor, activating it and prompting hyperplasia of the thyroid follicular epithelium along with unregulated release of thyroid hormones.
Presentation • individuals exhibit thyrotoxicosis accompanied by a diffuse goitre. • Certain individuals may additionally manifest a kind of orbital disease referred to as Graves' ophthalmopathy.
Macroscopy • The thyroid exhibits diffuse enlargement with a firm, red cut surface. • Following treatment, the thyroid may present a nodular morphology. Cytopathology: Aspirates exhibit significant cellularity with minimal colloid and many follicular epithelial cells demonstrating hyperplastic alterations. 2 Aspiration is seldom conducted in instances with active Graves' disease, as the clinical diagnosis is typically clear-cut. This is advantageous, as the highly cellular aspirates can readily be misidentified as a neoplastic process by the inattentive.
Histopathology • The thyroid exhibits diffuse hyperplasia characterized by colloid depletion and significant hyperplastic alterations of the follicular epithelium. • A heterogeneous lymphoid infiltrate, with or without germinal centers, is typically observed.
Prognosis: Excellent with adequate thyroid ablative therapy.
Definition: An autoimmune thyroid disorder marked by thyrotoxicosis and widespread hyperplasia of the thyroid gland.
Epidemiology • Prevalent, impacting up to 1% of the population. • The highest frequency occurs in young adults aged 30 to 40. • Women are disproportionately impacted compared to men.
Aetiology • Synthesis of antibodies that stimulate the TSH receptor. Pathogenesis TSH receptor-stimulating antibodies attach to the TSH receptor, activating it and prompting hyperplasia of the thyroid follicular epithelium along with unregulated release of thyroid hormones.
Presentation • individuals exhibit thyrotoxicosis accompanied by a diffuse goitre. • Certain individuals may additionally manifest a kind of orbital disease referred to as Graves' ophthalmopathy.
Macroscopy • The thyroid exhibits diffuse enlargement with a firm, red cut surface. • Following treatment, the thyroid may present a nodular morphology. Cytopathology: Aspirates exhibit significant cellularity with minimal colloid and many follicular epithelial cells demonstrating hyperplastic alterations. 2 Aspiration is seldom conducted in instances with active Graves' disease, as the clinical diagnosis is typically clear-cut. This is advantageous, as the highly cellular aspirates can readily be misidentified as a neoplastic process by the inattentive.
Histopathology • The thyroid exhibits diffuse hyperplasia characterized by colloid depletion and significant hyperplastic alterations of the follicular epithelium. • A heterogeneous lymphoid infiltrate, with or without germinal centers, is typically observed.
Prognosis: Excellent with adequate thyroid ablative therapy.
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