Patologia tiroidei

- Gusa coloida -
Definitie – marirea de volum a glandei
tiroide in absenta patologiei inflamatorii
sau tumorale.

Clasificare
Gusa simpla
Gusa multinodulara
Patogenie
• Carenta alimentara de iod (zone
endemice)
• Necesitati crescute - sarcina, alaptarea,
perioada de crestere.
• Femei peste 40 ani
• Istoric familial de gusa
• Alimente goitrogene – varza, conopida
• Administrare de medicamente –
sulfonamide, amiodarona, fenilbutazona
Simptome
 Dificultati respiratorii
 Astenie
 Disfagie
 Tumefierea glandei tiroide

Diagnostic paraclinic
 Dozarea T3, T4, TSH
 Scintigrafie tiroidiana cu substanta radioactiva
 Ecografie tiroidiana
 Macroscopie – gusa simpla

Aspectul macroscopic al tiroidei normale

Aspectul macroscopic al gusei simple

– tiroida difuz marita de volum , cu
suprafata externa si de sectiune
netede, culoare rosietica
 Macroscopie – gusa multinodulara

Aspectul macroscopic al gusei multinodulare – tiroida marita de volum, cu

caracter multinodular, traversata de benzi de fibroza
 Microscopie
Gusa simpla – proliferare difuza de foliculi tiroidieni de dimensiuni variabile
(caracter anizofolicular), delimitati de epiteliu aplatizat, cu continut de coloid
 Microscopie
Gusa multinodulara
– noduli alcatuiti din
foliculi dilatati de
dimensiuni variabile,
tapetati de epiteliu
aplatizat/hiperplazic
- septuri fibroase intre
noduli
- modificari
degenerative
(hemoragie, necroza,
fibroza, calcificare,
cristale de colesterol
- inflamatie
granulomatoasa la
nivel stromal
 Bibliografie
 Juan Rosai - “Surgical Pathology” vol I si II, ninth edition, Mosby
an affiliate of Elsevier Inc., 2004
 Robbins and Cotran – “Pathologic basis of disease” 9th edition,
Elsevier Saunders, 2014
 Silverberg’s – “Principles and practice of Surgical pathology and
cytopathology” vol. I si II, Churchill Livingstone Elsevier, 2006
 Fletcher C.D. – Diagnostic histopathology of tumors, 3rd Edition,
Churchill Livingstone, 2007.
 www.pathologyoutlines.com
 www.epathology.ro