第十篇章 内分泌系统疾病.ppt

内分泌系统疾病;;goiter;Diffuse nontoxic goiter;Ⅰ、Conception; 由于甲状腺素分泌不足、促甲状腺激素分泌增多，甲状腺滤泡上皮增生，胶质堆积而引起的甲状腺肿大。也称单纯性甲状腺肿，;2、分类;3、正常解剖组织学复习;The thyroid gland has a right lobe and a left lobe connected by a narrow isthmus. ;单层立方上皮;Normal thyroid seen microscopically consists of follicles lined by a an epithelium and filled with colloid.;This immunoperoxidase stain with antibody to calcitonin identifies the C cells ;immunofluorescence test positive for anti-microsomal antibody;immunofluorescence positivity for anti-thyroglobulin antibody;Ⅱ、Etiology;氨基酸;1、缺碘;Ⅲ、Pathogenesis;;Ⅳ、Pathological feature;1、Stage of hyperplasia;小滤泡大量增生，胶质少;2、 Stage of stored colloid ;滤泡扩张，大量胶质贮积;弥漫性胶样甲状腺肿;3、Stage of nodule;? The red arrow points to an area of scarring. ? The blue arrow points to a large and the yellow to a small follicle;The follicular cells have round to oval nuclei with small visible nucleoli. ? The follicle cell cytoplasm is scant ; 可见结节形成，部分滤泡显著 扩张，部分滤泡增生、萎缩。;? Enlarged thyroid with more enlargement on left. ? Left lobe also shows multiple nodules ;? Cut surface of one lobe of thyroid gland showing ill defined nodules. ? Focus of cystic degeneration seen (blue arrow). ? Some hemorrhage (red arrow) and some scarring. ;This diffusely enlarged thyroid gland is somewhat nodular. This patient was euthyroid; 甲状腺显著肿大， 有结节形成。;Ⅴ、Clinio- pathological relationship;;Diffuse toxic goiter;Ⅰ、Conception; 1、 定义： 指血中甲状腺素过多，作用于全身各组织所引起的临床综合症，临床上统称为甲状腺功能亢进症，简称“甲亢”，又称突眼性甲状腺肿。多见于女性, 男/女=1/4-6，以20-40岁最多见。;2、甲状腺激素的功能;Ⅱ、Etiology and Pathogenesis; 自身免疫性疾病;Ⅲ、Pathological feature;? Diffusely enlarged red tan thyroid gland. ? Slight lobulation but no large cyst formed. ;光镜：;A diffusely enlarged thyroid gland associated with hyperthyroidism is known as Graves disease. At low power here, note the prominent infoldings of the hyperplastic epithelium.;At high power, the tall columnar thyroid epithelium with Graves disease lines the hyperplastic infoldings in