Block 2 Case 1 Answers

1.  What antibodies are seen with this disease? antimicrosomal + thyroglobulin antibodies


2. You run a thyroid function test - what does it show? low thyroid hormone and high TSH


3. What is the diagnosis? Hashimotos


4. A biopsy of the thyroid is done and shown below - what are the key feature - name 2?

• germinal centers
• lymphocytic infiltrate

5. What form(s) of hypersensitiivity are seen in this condition? 

• cytotoxic T cells destroy the parenchyma - Type IV
• Antibodies against parencyma: Type II

6. What is the large straight arrow pointing to? 

• Hürthle cells are enlarged epithelial cells with eosinophilic cytoplasm and are found in biopsies of the thyroid in Hashimotos.  They occur when follicular cells undergo metaplastic changes due to a perpetual inflammatory state. This cell produces a negligable amount of thyroid hormone. 

7. What is within the circle?

• This is a shrunken follicles with plump cells surrounding it instead of the usual low cuboidal. The follicles are smaller because less hormone is being produced.

8. Plasma cells, lymphocyts, hurthle