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  #1  
Old 01-18-2012
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Default thyroid

A 40-year-old man sees his physician because of weight loss, increased appetite, and double vision. On physical
examination, his temperature is 37.7°C, pulse is 106/min, respirations are 15/min, and blood pressure is 140/80 mm Hg. A
fine tremor is observed in his outstretched hands. He has bilateral proptosis and corneal ulceration. Laboratory findings
include a serum TSH level of 0.1 μU/mL. A radioiodine scan indicates increased diffuse uptake throughout the thyroid. He
receives propylthiouracil therapy, and his condition improves. Which of the following best describes the microscopic
appearance of the patient's thyroid gland?
□ (A) Destruction of follicles, lymphoid aggregates, and Hürthle cell metaplasia
Robbins & Cotran Review of Pathology Pg. 487
□ (B) Papillary projections in thyroid follicles and lymphoid aggregates in the stroma
□ (C) Follicular destruction with inflammatory infiltrates containing giant cells
□ (D) Nodules with nests of cells separated by hyaline stroma that stains with Congo red
□ (E) Enlarged thyroid follicles lined by flattened epithelial cells
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  #2  
Old 01-18-2012
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oo tricky one

def not A (thats Hashimoto's, which is a hypothryoidism)
i don't think its C or D

either B or E

i'll guess E.
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Old 01-18-2012
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its E .... B is papillary ca ...
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  #4  
Old 01-19-2012
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Correct Answer the correct answer is > B

the clinical picture in this case indicated graves disease which is autoimmune with lymphocyte infiltrating the gland and papillary projectionsso the correct answer is B , while in papillary carcinoma i think he would say small cysts filled by papillary ingrowth and epithelium covering it is uniform and show few mitosis and encapsulated .
E which enlarged follicles lined by columnar cells occurs in iodine deficiency goiter
C> occurs in granulomatous thyroditis
A> in hashimoto
D> in medullary carcinoma
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