Reviewer: Shahidul Islam, M.D., Ph.D. (see Reviewers page) Revised: 10 June 2013, last major update March 2009 Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.
Autoimmune disorder with thyrotoxicosis, diffuse goiter, infiltrative ophthalmopathy and occasionally infiltrative dermopathy / pretibial myxedema (scaly thickening and induration of shin, seen late in disease in 5-10%)
Also thyroid acropachy-extremity swelling, clubbing of fingers and toes due to periosteal new bone formation, cardiac hypertrophy
Diffuse hyperplasia and hypertrophy of follicular cells with retention of lobular architecture and prominent vascular congestion
Tall follicular cells with papillae usually lacking fibrovascular cores
Nuclei are round, often polarized, rarely overlap, colloid is pale with scalloped margins (colloid doesn’t fill the lumen, and scalloping is a fixation artifact), lymphoid follicles represent autoimmune phenomena, mostly T cells; also oncocytes, fibrosis
Nuclear clearing (15%), florid papillary hyperplasia (13%, may resemble papillary thyroid carcinoma), nuclear grooves or pseudonuclear inclusions (8%), nuclear enlargement, multinucleation, pleomorphism or prominent nucleoli (7%), mitotic figures (6%), psammoma bodies (1%), hyperplastic follicles may extend into adjacent skeletal muscle (1%)
End of Thyroid gland > Hyperplasia / goiter > Graves’ disease
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