Thyroid adenoma

A thyroid adenoma is a benign tumor of the thyroid gland, that may be inactive or active (functioning autonomously) as a toxic adenoma. A thyroid adenoma may be clinically silent ("cold" adenoma), or it may be a functional tumor, producing excessive thyroid hormone ("warm" or "hot" adenoma). In this case, it may result in symptomatic hyperthyroidism, and may be referred to as a toxic thyroid adenoma. Thyroid follicular adenoma ranges in diameter from 3 cm on an average, but sometimes is larger (up to 10 cm) or smaller. The typical thyroid adenoma is solitary, spherical and encapsulated lesion that is well demarcated from the surrounding parenchyma. The color ranges from gray-white to red-brown, depending upon the cellularity of the adenoma the colloid content. Areas of hemorrhage, fibrosis, calcification, and cystic change, similar to what is found in multinodular goiters, are common in thyroid (follicular) adenoma, particularly in larger lesions. Almost all thyroid adenomata are follicular adenomata. Follicular adenomata can be described as "cold", "warm" or "hot" depending on their level of function. Histopathologically, follicular adenomata can be classified according to their cellular architecture and relative amounts of cellularity and colloid into the following types: Fetal (microfollicular) - these have the potential for microinvasion. These consist of small, closely packed follicles lined with epithelium. Colloid (macrofollicular) - these do not have any potential for microinvasion Embryonal (atypical) - have the potential for microinvasion. Hürthle cell adenoma (oxyphil or oncocytic tumor) - have the potential for microinvasion. Hyalinizing trabecular adenoma Papillary adenomata are very rare. A thyroid adenoma is distinguished from a multinodular goiter of the thyroid in that an adenoma is typically solitary, and is a neoplasm resulting from a genetic mutation (or other genetic abnormality) in a single precursor cell. In contrast, a multinodular goiter is usually thought to result from a hyperplastic response of the entire thyroid gland to a stimulus, such as iodine deficiency.

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vignette|Structure de la L-thyroxine (T4). vignette|Structure de la L-triiodothyronine (T3). Les hormones thyroïdiennes, c'est-à-dire la thyroxine (T4) la triiodothyronine (T3) et la diiodothyronine (T2), sont des hormones produites par les cellules folliculaires de la thyroïde à partir de la thyroglobuline et d'iodure. Il existe également la thyrocalcitonine, hormone produite par les cellules parafolliculaires de la thyroide et qui joue un rôle dans le métabolisme phospho-calcique.

Toxic multinodular goiter (TMNG), also known as multinodular toxic goiter (MNTG), is an active multinodular goiter associated with hyperthyroidism. It is a common cause of hyperthyroidism in which there is excess production of thyroid hormones from functionally autonomous thyroid nodules, which do not require stimulation from thyroid stimulating hormone (TSH). Toxic multinodular goiter is the second most common cause of hyperthyroidism (after Graves' disease) in the developed world, whereas iodine deficiency is the most common cause of hypothyroidism in developing-world countries where the population is iodine-deficient.

Un nodule thyroïdien est une masse de petite taille située au sein de la glande thyroïde, isolée ou multiple, le plus souvent bénin mais pouvant parfois être révélateur d'un cancer de la thyroïde. Un nodule est palpable au cours d'un examen systématique dans 4 à 7 % de la population générale, révélant un cancer de la thyroïde dans 8 à 16 % des cas. La fréquence de cette anomalie est bien supérieure à l'échographie. La prévalence s’accroît avec l'âge. Un nodule bénin est habituellement asymptomatique.

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