{"id":1570,"date":"2023-11-20T17:54:29","date_gmt":"2023-11-20T22:54:29","guid":{"rendered":"http:\/\/wordpress.forensicpath.us\/?p=1570"},"modified":"2023-11-20T17:56:49","modified_gmt":"2023-11-20T22:56:49","slug":"pathology-cases-hashimotos-thyroiditis","status":"publish","type":"post","link":"https:\/\/wordpress.forensicpath.us\/index.php\/2023\/11\/20\/pathology-cases-hashimotos-thyroiditis\/","title":{"rendered":"Pathology cases &#8212; Hashimoto&#8217;s thyroiditis"},"content":{"rendered":"<p>Here&#8217;s a classic example of severe lymphocytic thyroiditis in a middle-aged woman who died of unrelated causes.\u00a0 You can see in the whole slide panorama that much of the parenchyma of the thyroid has been replaced by lymphocytic aggregates with scattered germinal centers.\u00a0 Another common finding are so-called &#8220;Hurthle cells,&#8221; which are plump cells with eosinophilic cytoplasm and large nucleoli.\u00a0 The cytoplasmic change is said to by due to an abundance of mitochondria.\u00a0 I didn&#8217;t see them in this case.\u00a0 The textbooks say that the thyroid is often enlarged, but my experience is that it is more often pale and small. Maybe I only see late cases at autopsy.\u00a0 It often feels very firm to palpation if there&#8217;s some fibrosis.<\/p>\n<p>Here&#8217;s the panorama shot:<\/p>\n<p><a href=\"https:\/\/wordpress.forensicpath.us\/wp-content\/uploads\/2023\/11\/DSC_3769.small-DSC_3788.smallcropped.png\"><img fetchpriority=\"high\" decoding=\"async\" class=\"alignnone size-large wp-image-1571\" src=\"https:\/\/wordpress.forensicpath.us\/wp-content\/uploads\/2023\/11\/DSC_3769.small-DSC_3788.smallcropped-1024x556.png\" alt=\"\" width=\"688\" height=\"374\" srcset=\"https:\/\/wordpress.forensicpath.us\/wp-content\/uploads\/2023\/11\/DSC_3769.small-DSC_3788.smallcropped-1024x556.png 1024w, https:\/\/wordpress.forensicpath.us\/wp-content\/uploads\/2023\/11\/DSC_3769.small-DSC_3788.smallcropped-300x163.png 300w, https:\/\/wordpress.forensicpath.us\/wp-content\/uploads\/2023\/11\/DSC_3769.small-DSC_3788.smallcropped-768x417.png 768w, https:\/\/wordpress.forensicpath.us\/wp-content\/uploads\/2023\/11\/DSC_3769.small-DSC_3788.smallcropped-1536x833.png 1536w, https:\/\/wordpress.forensicpath.us\/wp-content\/uploads\/2023\/11\/DSC_3769.small-DSC_3788.smallcropped-1600x868.png 1600w, https:\/\/wordpress.forensicpath.us\/wp-content\/uploads\/2023\/11\/DSC_3769.small-DSC_3788.smallcropped.png 2048w\" sizes=\"(max-width: 688px) 100vw, 688px\" \/><\/a><\/p>\n<p>Here&#8217;s a medium power:<\/p>\n<p><a href=\"https:\/\/wordpress.forensicpath.us\/wp-content\/uploads\/2023\/11\/DSC_3765.small_.jpg.divide.jpg.white_balanced-scaled.jpg\"><img decoding=\"async\" class=\"alignnone size-large wp-image-1572\" src=\"https:\/\/wordpress.forensicpath.us\/wp-content\/uploads\/2023\/11\/DSC_3765.small_.jpg.divide.jpg.white_balanced-1024x683.jpg\" alt=\"\" width=\"688\" height=\"459\" srcset=\"https:\/\/wordpress.forensicpath.us\/wp-content\/uploads\/2023\/11\/DSC_3765.small_.jpg.divide.jpg.white_balanced-1024x683.jpg 1024w, https:\/\/wordpress.forensicpath.us\/wp-content\/uploads\/2023\/11\/DSC_3765.small_.jpg.divide.jpg.white_balanced-300x200.jpg 300w, https:\/\/wordpress.forensicpath.us\/wp-content\/uploads\/2023\/11\/DSC_3765.small_.jpg.divide.jpg.white_balanced-768x512.jpg 768w, https:\/\/wordpress.forensicpath.us\/wp-content\/uploads\/2023\/11\/DSC_3765.small_.jpg.divide.jpg.white_balanced-1536x1024.jpg 1536w, https:\/\/wordpress.forensicpath.us\/wp-content\/uploads\/2023\/11\/DSC_3765.small_.jpg.divide.jpg.white_balanced-2048x1365.jpg 2048w, https:\/\/wordpress.forensicpath.us\/wp-content\/uploads\/2023\/11\/DSC_3765.small_.jpg.divide.jpg.white_balanced-1600x1067.jpg 1600w\" sizes=\"(max-width: 688px) 100vw, 688px\" \/><\/a><\/p>\n<p>And higher power.\u00a0 Note that the remaining follicles are small and a bit involuted.\u00a0 The parenchyma is largely replaced by lymphocytes with a prominent germinal center.\u00a0 Fibrosis is not a prominent feature here.<\/p>\n<p><a href=\"https:\/\/wordpress.forensicpath.us\/wp-content\/uploads\/2023\/11\/DSC_3789.small_.jpg.divide.jpg.white_balanced-scaled.jpg\"><img decoding=\"async\" class=\"alignnone size-large wp-image-1573\" src=\"https:\/\/wordpress.forensicpath.us\/wp-content\/uploads\/2023\/11\/DSC_3789.small_.jpg.divide.jpg.white_balanced-1024x683.jpg\" alt=\"\" width=\"688\" height=\"459\" srcset=\"https:\/\/wordpress.forensicpath.us\/wp-content\/uploads\/2023\/11\/DSC_3789.small_.jpg.divide.jpg.white_balanced-1024x683.jpg 1024w, https:\/\/wordpress.forensicpath.us\/wp-content\/uploads\/2023\/11\/DSC_3789.small_.jpg.divide.jpg.white_balanced-300x200.jpg 300w, https:\/\/wordpress.forensicpath.us\/wp-content\/uploads\/2023\/11\/DSC_3789.small_.jpg.divide.jpg.white_balanced-768x512.jpg 768w, https:\/\/wordpress.forensicpath.us\/wp-content\/uploads\/2023\/11\/DSC_3789.small_.jpg.divide.jpg.white_balanced-1536x1024.jpg 1536w, https:\/\/wordpress.forensicpath.us\/wp-content\/uploads\/2023\/11\/DSC_3789.small_.jpg.divide.jpg.white_balanced-2048x1365.jpg 2048w, https:\/\/wordpress.forensicpath.us\/wp-content\/uploads\/2023\/11\/DSC_3789.small_.jpg.divide.jpg.white_balanced-1600x1067.jpg 1600w\" sizes=\"(max-width: 688px) 100vw, 688px\" \/><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Here&#8217;s a classic example of severe lymphocytic thyroiditis in a middle-aged woman who died of unrelated causes.\u00a0 You can see&hellip;<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[99,109,60],"tags":[59,56,25,28,26,111],"class_list":["post-1570","post","type-post","status-publish","format-standard","hentry","category-forensic-pathology","category-pathology-cases","category-photomicrographs","tag-autopsy","tag-histology","tag-microscopy","tag-pathology","tag-photomicrography","tag-thyroid"],"_links":{"self":[{"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/posts\/1570","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/comments?post=1570"}],"version-history":[{"count":3,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/posts\/1570\/revisions"}],"predecessor-version":[{"id":1576,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/posts\/1570\/revisions\/1576"}],"wp:attachment":[{"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/media?parent=1570"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/categories?post=1570"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/tags?post=1570"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}