Pathomorphology of Thyroid Diseases (Goiter)

A. Definition
B. Types of Goiter
1. Endemic Goiter
2. Sporadic Goiter
C. Causes
1. Iodine Deficiency
2. Autoimmune Disorders
D. Pathological Changes
1. Hyperplasia of Thyroid Follicular Cells
2. Colloid Accumulation
E. Clinical Features
1. Swelling in Neck
• 2. Hormonal Imbalance
Pathomorphology of Thyroid Diseases
(Goiter)
• Goiter is an abnormal enlargement of the thyroid gland, often characterized
by a visible swelling in the neck. It results from various causes, including
iodine deficiency and autoimmune disorders, leading to changes in the
thyroid tissue structure.
• TYPES OF GOITRE-
• 1. Endemic Goiter:
• - Cause: Typically results from insufficient dietary iodine intake in a specific
geographic area.
• - Prevalence: Common in regions with low iodine levels in the soil and water.
• - Pathological Features: Characterized by diffuse enlargement of the thyroid
gland due to hyperplasia of follicular cells.
2. Sporadic Goiter:
Cause: Occurs individually and can result from various underlying factors,
such as genetic predisposition or exposure to substances known as
goitrogens, which interfere with thyroid function.
Prevalence: Not limited to specific regions; it occurs sporadically and can be
found in different geographic areas.
• Pathological Features: This type of goiter may show either nodular or focal
enlargement of the thyroid gland, accompanied by diverse cellular changes.
• # Cause :
• 1. Iodine Deficiency:
• - Explanation: Goiter often results from insufficient dietary intake of iodine,
a crucial element for thyroid hormone synthesis.
• - Effect: Inadequate iodine levels can lead to impaired thyroid function,
causing the gland to enlarge in an attempt to compensate for the deficiency.
2. Autoimmune Disorders:
Explanation: Goiters can arise from autoimmune conditions, indicating
situations where the immune system of the body erroneously identifies
and harms the thyroid tissue.
• Effect: An example of this is autoimmune thyroiditis, a condition
causing persistent inflammation and changes in the structure of the
thyroid. This contributes to the formation and progression of goiter.
• Pathological Changes:
• 1. Hyperplasia of Thyroid Follicular Cells:
• - Description: Goiter often involves the excessive growth (hyperplasia)
of thyroid follicular cells, the basic structural units of the thyroid gland.
• - Effect: This increased cell proliferation contributes to the enlargement
of the thyroid gland, a characteristic feature of goiter.
2. Colloid Accumulation:
Description: Colloid refers to a substance found within thyroid follicles,
serving as a storage site for thyroid hormones produced by the thyroid gland.
• Effect: In the context of goiter, there is an abnormal accumulation or
buildup of colloid within the thyroid follicles. This accumulation can
contribute to the overall enlargement of the thyroid gland, leading to
changes in its normal structure and potentially affecting its proper
functioning.
• #Clinical Features
• 1. Swelling in Neck:
• - Presentation: A visible enlargement or swelling in the neck region is a
prominent clinical feature of goiter.
• - Observation: This swelling may be easily noticeable and is often located in
the area where the thyroid gland is situated.
2. Hormonal Imbalance:
Presentation: In the context of goiter, there can be disturbances in
hormonal balance, specifically impacting the normal secretion of
thyroid hormones by the thyroid gland.
• Effects: These hormonal imbalances can manifest as various
symptoms, including alterations in metabolism, fluctuations in
energy levels, and changes in body weight. The thyroid hormones
play a crucial role in regulating these physiological processes, and
disruptions can lead to noticeable effects on the body’s overall
function.
Pathomorphology of Diabetes Mellitus
A. Definition
B. Types of Diabetes
1. Type 1 Diabetes
2. Type 2 Diabetes
C. Causes
1. Autoimmune Reaction (Type 1)
2. Insulin Resistance (Type 2)
D. Pathological Changes
1. Islet Cell Destruction (Type 1)
2. Beta-cell Dysfunction (Type 2)
E. Clinical Features
1. Hyperglycemia
• 2. Polyuria, Polydipsia, Polyphagia
Pathomorphology of Diabetes Mellitus
• Diabetes Mellitus is a chronic metabolic disorder characterized by elevated blood
glucose levels. It occurs due to insufficient insulin production or ineffective use of
insulin, leading to pathological changes in pancreatic islets (Type 1) or insulin
resistance (Type 2). Clinical manifestations include increased thirst, hunger, and
frequent urination.
• # Types of Diabetes
• 1. Type 1 Diabetes:
• An autoimmune condition where the immune system attacks and destroys
insulin-producing beta cells in the pancreas.
• - Characteristics: Insulin deficiency, requiring lifelong insulin replacement therapy.
• - Onset: Typically diagnosed at a younger age.
2. Type 2 Diabetes:
Description: Type 2 diabetes is characterized by insulin resistance, a
condition where the body’s cells do not respond effectively to insulin,
and there’s a gradual decline in insulin production by the pancreas.
• Characteristics: This type of diabetes is often associated with various
factors, including lifestyle choices, genetic predisposition, and obesity.
• C. Causes:
• 1. Autoimmune Reaction (Type 1):
• - Explanation: Type 1 diabetes is primarily caused by an autoimmune
reaction where the immune system mistakenly targets and destroys
insulin-producing beta cells in the pancreas.
• - Effect: The destruction of these cells results in a lack of insulin,
leading to elevated blood glucose levels.
2. Insulin Resistance (Type 2):
Explanation: In Type 2 diabetes, there is a notable feature known as insulin
resistance, wherein cells in the body do not respond effectively to insulin’s signals.
This condition results in an increased demand for insulin to facilitate glucose
uptake by cells.
• Effect: Over time, the pancreas, responsible for producing insulin, may face
challenges in meeting the heightened demand. This struggle to maintain
sufficient insulin levels contributes to elevated blood sugar levels, a hallmark
characteristic of Type 2 diabetes.
• # Pathological Changes:
• 1. Islet Cell Destruction (Type 1):
• - Description: In Type 1 diabetes, there is a destructive autoimmune process
targeting the insulin-producing beta cells in the pancreatic islets.
• - Effect: This immune-mediated destruction leads to a severe deficiency of
insulin, resulting in impaired glucose regulation and elevated blood sugar
levels.
2. Beta-cell Dysfunction (Type 2):
Description: In Type 2 diabetes, there is dysfunction of the insulin-
producing beta cells located in the pancreas. Unlike Type 1 diabetes, these
cells are not completely destroyed.
• Effect: Over time, the beta cells experience a reduction in their
effectiveness to produce insulin. This dysfunction contributes to insulin
deficiency, making it challenging for the body to maintain normal blood
glucose levels. The gradual decline in beta-cell function is a key aspect of
the progression of Type 2 diabetes.
• # clinical features :
• 1. Hyperglycemia:
• - Presentation: Elevated blood glucose levels characterize hyperglycemia,
a common clinical feature in both Type 1 and Type 2 diabetes.
• - Effects: Prolonged hyperglycemia can lead to symptoms such as
increased thirst, frequent urination, and fatigue.
2. Polyuria, Polydipsia, Polyphagia:
Polyuria: Excessive urination, a result of the kidneys working to
eliminate excess glucose from the bloodstream, leading to increased
urine production.
Polydipsia: Excessive thirst, a natural response to dehydration caused
by the increased urination. The body attempts to compensate for fluid
loss.
• Polyphagia: Increased hunger, stemming from the fact that despite
elevated blood sugar levels, the body’s cells may be deprived of
glucose due to insulin-related issues. This triggers a sensation of
hunger as the body seeks additional energy.
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