HASHIMOTO'S THYROIDITIS: Etiopathogenesis, Morphology & Complications скачать в хорошем качестве

HASHIMOTO'S THYROIDITIS: Etiopathogenesis, Morphology & Complications

Hashimoto’s thyroididtis ***Follow me**** http://ilovepathology.com/ Twitter :   / vijaypatho     / ilovepathology2   Facebook:   / ilovepathology   Most common cause of hypothyroidism in areas where iodine levels are sufficient. Gradual thyroid failure due to autoimmune destruction of thyroid gland Definition: It is Characterized by 1. Diffuse goitrous enlargement of the thyroid 2. Lymphocytic infiltration of the thyroid gland 3. Presence of thyroid autoantibodies. Age incidence: 45 - 65yrs. Male: Female: 1:10 to 1:20 It can occur in children and is a major cause of nonendemic goiter in children. 1. Genetic predisposition. 2. Immune causes: Autoantibody production 3. Environmental factors: In a genetically susceptible individual environmental factors, such as infection, dietary factors (iodine), stress and pregnancy, may initiate autoimmunity in the thyroid. Genetic predisposition:HLA-DR3 & DR5 Immune causes Immune Regulatory Genes [CTLA4, PTPN22] cytotoxic T lymphocyte–associated antigen-4 (CTLA4) protein tyrosine phosphatase-22 Thyroid specific genes (thyroglobulin and thyroid-stimulating hormone [TSH] receptor ) GROSS -Diffuse enlargement , may be Nodular Gland well demarcated Cut section; Pale, yellow tan, rubbery to firm/nodular MICRO Atrophy of the follicles Diffuse infiltration by mononuclear cells Formation of lymphoid follicles Hurthle cell metaplasia Interstitial connective tissue may be increased Clinical features : Middle aged women Painless enlargement Variable degree of hypothyroidism Laboratory findings: T3 & T4 decreased TSH increased Antithyroid antibodies Diagnostic tests: FNAC HPE of Biopsy COMPLICATIONS Hashitoxicosis B-cell Non Hodgkin Lymphoma Increased risk for other autoimmune diseases Diabetes type 1, Adrenalitis, SLE, Myasthenia Gravis.. Increased risk(variable) thyroid epithelial neoplasms.. Papillary Carcinoma ~-~~-~~~-~~-~ Please watch: "WARBURG EFFECT: Hallmark of CANCER. What, Why & How?"    • NEOPLASIA 6: WARBURG EFFECT: Hallmark of  ...   ~-~~-~~~-~~-~