27. Graves disease

Staining: HE

Overview

Organ: Thyroid

Description: Normal thyroid follicles are replaced by two types of abnormal follicles:

• Hypertrophic follicles
• Follicles with resorption vacuoles

The follicular cells of the hypertrophic follicles are hypertrophic (large). These follicles have no visible lumen or colloid substance. Due to the hyperactivity of the thyroid follicular cells these cells will quickly consume colloid. This leaves behind small “vacuoles” that line the follicular cells. It looks like the follicular cells “take a bite” out of the colloid substance.

As Graves disease is an autoimmune disease, which is chronic by definition, lymphocytic infiltration is present as well.

Resorption vacuoles

Diagnosis: Graves disease

Risk factors:

• Young females

Theory:

Nothing special.

Hypertrophic follicles

Lymphocytic infiltrate