1. Department of pathology Li shuhua

2. nontoxic goiter Toxic goiter adenoma adenocarcinoma

4. Diffuse nontoxic goiter Pathogenesis: Dietary iodine deficiency endemic Not apparent sporadic Impaired synthesis of thyroid hormone Rise TSH level in serum Hypertrophy and hyperplasia of thyroid follicular cells Gross enlargement of the thyroid gland

5. morphology Diffuse hyperplastic goiter Diffuse colloid goiter Nodular goiter

6. Diffuse hyperplastic goiter 1.Diffuse ， symmetric enlargement of the gland; <150g 2. follicle are lined by crowded columnar cells, which may pile up and form projections. There is only little colloid in the follice

8. Diffuse colloid goiter 1.Cut surface: brown, glassy, translucent; 200-300g 2.Colloid is abundant in the follicles; 3.follicular epithelium are flattened or cuboidal or hyperplasia.

9. 非毒性弥漫性甲状腺肿

10. Nodular goiter macroscopically: Multilobulated, asymmetrically enlarged glands Cut surface: irregular nodules containing variable amount of brown,gelatinous colloid;

11. microscopically 1.Regressive changes: fibrosis, hemorrhage, calcification, cystic 2.Colloid-rich follicles lined by flattened epithelium and areas of follicular epithelial hypertrophy and hyperplasia;

12. 非毒性结节性甲状腺肿

13. Diffuse toxic goiter (grave’s disease) Pathogenesis: autoimmune disorder

14. Morphology: 1.diffusely enlarged, gland is smooth and soft,capsule is intact 2.microscopically: follicular epithelial cells are tall,columnar,crowed, formation of small papillae; colloid is pale with scalloped margins. 3.vessel and lymphoid aggregates

15. 甲状腺机能亢进

16. Clinical features diffuse hyperplasia of the thyroid, ophthalmopathy, dermopathy

17. 甲状腺肿大

19. adenomas 1.solitary, spherical, encapsulated lesion 2.cut surface:gray white to red brown; regressive change 3.microscopically :form relatively uniform, normal- appearing follicles that contain colloid. 4. Well-defined, intact capsule 5.histologic subtypes

20. 甲状腺腺瘤

21. 滤泡性甲状腺腺瘤

22. 胚胎性腺瘤

23. 胎儿型腺瘤

24. 嗜酸性腺瘤

25. carcinoma 1.papillary carcinoma 2.follicular carcinoma 3.medullary carcinoma 4.anaplastic carcinoma

27. 乳头状腺癌

28. 滤泡性腺癌

30. 髓样癌

32. 未分化癌