Endocrine System

Thyroid Gland, Follicle, Epithelium - Hyperplasia

Narrative
Comment:
Hyperplasia of follicular epithelium may be focal, diffuse, or sometimes cystic. Focal or multifocal follicular hyperplasia can be present in a single or in a few follicles. Focal hyperplasia is not encapsulated and does not compress surrounding parenchyma, which differentiates it from benign tumors. Affected follicles may be small with minimal colloid or large and irregular with papillary projections of hyperplastic epithelium extending into the follicular lumen (Figure 1 and Figure 2). Thyroid follicular hypertrophy and hyperplasia often occur together (Figure 3). Hyperplasia characterized by crowding of follicular epithelium nuclei and minimal protrusion into the follicular lumen may occur (Figure 4).
Recommendations:
Although follicular hyperplasia can occur spontaneously, it should be diagnosed and given a severity grade whenever present. Severity may be based on the percentage of the gland involved and the morphologic complexity of the hyperplasia. The nature and extent of the hyperplasia and whether it is unilateral or bilateral should be described in the pathology narrative. Distinction between focal, diffuse, and cystic thyroid follicular hyperplasia is recommended and should be included as a qualifier of the diagnosis. The nature of any associated hypertrophy in follicles with hyperplasia should not be diagnosed separately, unless warranted by severity. If not diagnosed, hypertrophy should be described in the pathology narrative.
References:

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Abstract: http://www.ncbi.nlm.nih.gov/pubmed/2675279

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Abstract: http://www.sciencedirect.com/science/book/9780123302151

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Abstract: http://www.ncbi.nlm.nih.gov/pubmed/199066

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Abstract: http://www.sciencedirect.com/science/book/9780444527714

Hardisty JF, Boorman GA. 1990. Thyroid gland. In: Pathology of the Fischer Rat: Reference and Atlas (Boorman GA, Eustis SL, Elwell MR, Montgomery CA, MacKenzie WF, eds). Academic Press, San Diego, 519–536.

Abstract: http://www.ncbi.nlm.nih.gov/nlmcatalog/9002563

Hardisty JF, Boorman GA. 1999. Thyroid and parathyroid glands. In: Pathology of the Mouse: Reference and Atlas (Maronpot RR, Boorman GA, Gaul BW, eds). Cache River Press, Vienna, IL, 537–554.

Abstract: http://www.cacheriverpress.com/books/pathmouse.htm

Hood A, Hashmi R, Klaassen CD. 1999. Effects of microsomal enzyme inducers on thyroid-follicular cell proliferation, hyperplasia, and hypertrophy. Toxicol Appl Pharmacol 160:163-170.

Abstract: http://www.ncbi.nlm.nih.gov/pubmed/10527915

Hooth MJ, Deangelo AB, George MH, Gaillard ET, Travlos GS, Boorman GA, Wolf DC. 2001. Subchronic sodium chlorate exposure in drinking water results in a concentration-dependent increase in rat thyroid follicular cell hyperplasia. Toxicol Pathol 29:250-259.

Full Text: http://tpx.sagepub.com/content/29/2/250.full.pdf
  • Image of follicle epithelium hyperplasia in the thyroid gland from a male B6C3F1 mouse in a chronic study

    Thyroid gland, Follicle, Epithelium - Hyperplasia in a male B6C3F1 mouse from a chronic study. Higher magnification of Figure 1 shows the proliferative projections of hyperplastic epithelium in more detail.

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