Endocrine Pathology, Case 4 60-year-old previously healthy woman presents with fatigue and cold intolerance. She has had about 10 pound weight gain over the past 6 months which she attributes to inactivity. On physical exam the thyroid gland is diffusely enlarged. No nodules are palpated. No cervical LAD is present.

Identify the organ. Describe the gross findings The surgical specimen consists of the entire thyroid gland plus a substernal, accessory lobe (arrow). The accessory lobe is bisected. The cut surface is tan. Histologic examination supported the diagnosis of Hashimoto Thyroiditis. Why is the color different that the color of a normal or hyperplastic thyroid gland? The abundant lymphocytes which infiltrate the tissue give it a tan hue.

Describe the low power histologic findings. Germinal center Lymphocytes and plasma cells Fibrous tissue Thyroid follicles Describe the low power histologic findings. Section of the thyroid shows that the normal architecture is disrupted by bands of fibrous tissue and an intense infiltrate of lymphocytes and plasma cells. Occasional germinal centers are present

Describe the high power histologic findings Follicular cells with abundant, eosinophilic, granular cytoplasm, termed Hurthle cell metaplasia, are present