Endocrine system pathology

Transcription

1 Endocrine system pathology

2 Central endocrine system peripheral endocrine system: thyroid gland parathyroid gland pancreas adrenal glands

3 Thyroid gland. the weight of normal thyroid gland is about 15 grams. under the response of TSH of the hypothalamus, the.... thyroid gland secrete thyroxin (T4) and thiiodotheratine. the thyroid gland has a vary important metabolic function. increase in thyroid function called hyperthyroid. decrease in thyroid function called hypothyroid

4 1. Inflammation 2. Tumors Diseases of thyroid gland

5 thyroid gland Hyperthyroidism. A clinical syndrome caused by excessive circulating thyroid gland. Thy caused by increased tissue metabolic activity. Thy characterized by nervousness, heat intolerance weight loss, palpitation, and increase appetite

6 Graves disease 1. The most common cause of endogenous hyperthyroidism 2. Usually characterized by diffuse enlargement of thyroid 3. Usually present with exophlalmos 4. Usually present with myxedema (thinning and mild hyperpegmentation of the pretibial skin) 5. The women affected seven times more than men 6. The cause is an autoimmune disease, antibodies that cause thyroid stimulation and overfunction 7. The thyroid hormones are very high, and the TSH is very low

7 hypothyroidism A condition caused by low thyroid gland hormone It is characterized by hoarseness, cold intolerance, increase weight

8 thyroiditis Hashemoto thyroiditis (chronic lymphocytic thyroiditis) The most common cause of hypothyroidism in areas with normal iodine level It is characterized by gradual thyroid failure because of autoimmune destruction of thyroid gland It is characterized by a painless symmetrical enlargement the thyroid gland Usually it is associated with other autoimmune diseases such as DM type I Usually associated with some malignancy such as non- Hodgkin lymphoma

9 Goiter. Can be diffuse or multinodular goiter. Caused by dietary iodine deficiency, (endemic goiter) which is important for the synthesis of thyroid hormones. Low thyroid hormones leads to stimulate TSH secretion, hypertrophy and hyperplasia of thyroid gland. Started as diffuse simple goiter, involves the whole gland without causing nodularity. After a long time (if not treated ), it becomes irregular, hard, nodular (multinodular)

10 carcinoma of thyroid Papillary carcinoma Follicular carcinoma Medullary carcinoma Anaplastic carcinoma Thyroid carcinoma account about 1.5% of all human cancers, the are more common in female for unknown cause, they are usually in adults

11 Papillary carcinoma of thyroid. Is the most common type (80%). Can present in young before age 20. The majority are associated with previous irradiation. About 9% of patients with such irradiation developed papillary carcinoma during there life. They can present with hoarseness, dysphagia, cough. Papillary carcinoma has an excellent prognosis(10 year survival more than 95%)

12 Papillary carcinoma of thyroid

13 Parathyroid glands. Four glands are present close to the upper and lower poles of thyroid gland. The gland secretes parathyroid hormone( PTH). The main function of PTH is calcium level controlling (when Ca++ level is low, PTH is higher). PTH level is usually high in patients with chronic renal failure( secondary hyperparathyroidism). Patents with high PTH has high calcium and low phosphorus

14 Causes of hyperparathyroidism primary causes 1. Adenoma 75% to 80% 2. primary hyperplasia 10% to 15% 3. parathyroid carcinoma less than 5% Secondary causes usually with chronic renal failure Causes of hypoparathyroidism The most common cause is surgically induced during thyroid gland surgery

15 Adrenal gland The adrenal gland has two parts Cortex- outer, synthesizes three types of hormones 1. Glucocorticoids (cortisol) 2. Mineralcorticoids (aldesterone) 3. Sex steroids(estrogen and androgen) Medulla- inner the adrenal medulla synthesizes and secrete cathecholamines mainly adrenaline

16 Causes hypercortisolism (Cushing syndrome). Most cases of Cushing syndrome are the result of administration of exogenous glucocorticoidis to treat many diseases Other causes are: 1.High ACTH from the hypothalamus 2.High cortisol by adrenal adenoma 3. High ectopic ACTH by different neoplasm Clinical picture accumulation of fat in the posterior neck Central obesity, polydypsia, hyperglycemia, hirsutism, moon face

17 Diabetes Mellitus Type I : absolute deficiency of insulin caused by pancreatic B cell destruction( 10% of all diabetes mellitus), usually associated with genetic disease, Type II: combination of peripheral resistance to insulin action and inadequate secretory response by pancreatic B- cell relative insulin deficiency

18 involved organs Blood vessels Kidney Retinal disease Neuropath Diabetes Mellitus

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