Endocrine Tumors and Diabetes Mellitus Quiz

Endocrine Lab - Fall 2024

• Course offered by the Faculty of Medicine at Gala University.

Thyroid Gland

• Subacute Thyroiditis (Giant cell-De Quervan's granulomatous thyroiditis):

  • Histological sections show destroyed follicles
  • Presence of acute and chronic inflammatory cells
  • Granulomatous reaction around colloid fragments and foreign bodies.

• Multinodular Goiter:

  • Enlarged thyroid gland with a nodular surface.
  • Characterized by numerous irregular nodules.
  • Some follicles are distended with colloid, while others are collapsed.
  • Large colloid-containing follicles may fuse to form larger cysts.
  • Epithelial cells range from flat cuboidal to columnar.

• Hashimoto's Thyroiditis:

  • Enlarged thyroid gland, firm to the touch.
  • Weighs approximately 160 grams.
  • Cut surface is pale tan and fleshy, with a vaguely nodular pattern.

• Papillary Thyroid Carcinoma:

  • Thyroid gland nodule
  • White to yellowish cut section with calcified areas.
  • Papillae visible grossly.
  • Branching of papillae consisting of fibrovascular core with cuboidal/columnar stratified lining.
  • Characterized by nuclear features; clear/ground-glass (Orphan Annie) nuclei and nuclear grooves.

• Follicular Thyroid Carcinoma:

  • Thyroid gland mass with a microfollicular pattern.
  • Apparent capsular invasion (marked by an arrow).

Parathyroid Gland

• Parathyroid Adenoma:
  • Predominantly composed of chief cells
  • Cells arranged in sheets and cords.

Pituitary Gland

• Pituitary Adenoma:
  • Abundant cytoplasm with uniform nuclear morphology.
  • Stippled chromatin and inconspicuous nucleoli.
  • Cytoplasmic appearance typically correlates with hormone content of secretory cells.

Adrenal Gland

• Adrenal Cortical Carcinoma:

  • Section in the adrenal gland cortex.
  • Tumor cells with large nuclei and prominent nucleoli.
  • Prominent mitotic figures are visible.
  • Confluent areas of necrosis may be present.

• Pheochromocytoma:

  • Adrenal gland medullary mass.
  • Tumor cells with abundant basophilic cytoplasm,
  • Prominent cell nesting pattern(zellballen).
  • Ultrastructural features characterized by abundant secretory granules.
  • Norepinephrine-containing granules with a halo between the core and membrane.

• Immunohistochemistry (Pheochromocytoma):

  • Adrenal gland medullary mass.
  • Positive Chromogranin A.

Endocrine Part of Pancreas

• Islet of Langerhans (Immunohistochemical Staining):

  • Immunoperoxidase staining helps differentiate cells.
  • Beta cells (70%, central) are rectangular with a halo, positive for insulin.
  • Alpha cells (20%, peripheral) are round with a halo, positive for glucagon.

• Type 1 Diabetes Mellitus (Insulitis):

  • Lymphocytic infiltrates in an edematous islet.
  • Suggests an autoimmune mechanism.
  • Complete destruction of islets results in lack of insulin.

• Type 2 Diabetes Mellitus (Amyloid Deposition):

  • Islet of Langerhans with pink hyalinization(amyloid) in many islet cells.

• Pancreatic Neuroendocrine Tumor:

  • Tumor with cells resembling islet cells, separated from the pancreas by a thin capsule.
  • Functional tumours may lead to hypoglycemia or ulcerative conditions (e.g., Zollinger-Ellison Syndrome).
  • Insulinoma is a pancreatic neuroendocrine tumor positive for insulin.