1.1 Pathology of the Endocrine System: General

T/F endocrine organs tend to be small and widely spaced and are not associated with the nervous system

False; they are small and widely spaced and ARE associated with the nervous system

endocrine organs tend to have rich __________ and are interconnected because they need to be able to deliver stuff throughout the body

vasculature

what are the five S's that describe endocrine organ function?

sense

synthesize

store

secrete

signal

what are four examples of molecules that endocrine organs synthesize?

steroids

polypeptides

iodothyronines

catecholamines

what are the three general ways that molecules can be transported from one cell to another? (Think back to year one histo)

endocrine

paracrine

autocrine

what are the three general pathology patterns Koehler developed to describe pathologies that affect endocrine organs?

somethings been added

somethings been taken away

somethings not made right

(can be one or a combo of these)

what are three things that can be added with endocrine organ pathologies?

cells (hyperplasia, neoplasia, inflammatory vessels)

fluid (intra/extracellular)

ECM

T/F hyperplasia indicates a normal response to increased stimulus

true

what are two things that can be taken away with endocrine organ pathologies?

cells (atrophy, apoptosis, necrosis)

ECM (produced by cells that have been lost)

what two things can be "not made right" when it comes to endocrine organ pathologies?

organ or tissue (aplasia, hypoplasia, dysplasia)

vasculature (hamartoma, AV anastomosis)

What are examples of proliferative lesions (something added) of endocrine organs? (3)

nodular hyperplasia

adenoma

carcinoma

How do nodular hyperplastic lesions in endocrine glands differ from physiological hyperplasia? (6)

nodular lesions:

Are not a fully reversible process

are focal, not diffuse

may grow autonomously

may be either clonal or polyclonal in nature

Both hypo and hyperfunction of the gland are possible

may or may not progress to neoplasia

What does "nodular hyperplastic lesions in endocrine glands may grow autonomously" mean?

the nodule can be made independent of stimulus

(does not require lots of hormone to grow as conventional hyperplasia)

nodular hyperplasia of endocrine organs are lesions that:

A are usually solitary and unilateral

B has one to multiple generally small nodules; uni/bilateral (but usually uni)

C are usually solitary and unilateral but can be bilateral

B

adenomas of endocrine organs are lesions that:

A are usually solitary and unilateral

B has one to multiple generally small nodules; uni/bilateral (but usually uni)

C are usually solitary and unilateral but can be bilateral

A

carcinomas of endocrine organs are lesions that:

A are usually solitary and unilateral

B has one to multiple generally small nodules; uni/bilateral (but usually uni)

C are usually solitary and unilateral but can be bilateral

C

Nodular hyperplasia of endocrine organs are lesions that are:

A well demarcated, not encapsulated

B poorly demarcated, not encapsulated

C well demarcated, encapsulated

A

Adenomas of endocrine organs are lesions that are:

A well demarcated, not encapsulated

B poorly demarcated, not encapsulated

C well demarcated, encapsulated

C

Carcinomas of endocrine organs are lesions that are:

A well demarcated, not encapsulated

B poorly demarcated, not encapsulated

C well demarcated, encapsulated

B

How do cells look histologically with nodular hyperplasia?

Normal

How do cells look histologically with Adenomas?

normal...ish (cells deviate from perfectly normal arrangement but not by much)

what are two very reliable indicators of malignancy?

vasculature invasion

metastasis

T/F adenomas are more likely to be bilateral than carcinomas

false; its the opposite

Size is a feature of malignancy, how do carcinomas of endocrine organs compare in size to adenomas?

Carcinomas tend to be larger

What can rapid growth of malignant tumors in endocrine organs lead to?

necrosis and hemorrhage

how do cells of malignant tumors in endocrine organs compare to nonmalignant cells?

cells are more pleomorphic

mitotic figures present, can be atypical

what are two ways that endocrine malignancies can invade the tissues?

intraglandular (invade through capsule/tissue)

intravascular (hella blood goes to endocrine organs 🧚♀️)

Where do many endocrine tumors like to metastasize to and why?

lungs, liver, and bone

because they are blood rich organs

T/F benign proliferative lesions of endocrine organs are always non functional (don't secrete hormones) and malignant proliferative lesions are always functional

False; functional vs nonfunctional is separate and different from benign vs malignant! I.e., a benign tumor can secrete and a malignant tumor could not and vice versa (both benign and malignant tumors can be either functional or nonfunctional)

Functional proliferative lesions of endocrine organs secrete excess ________ continuously or episodically. (Choose one: atrophy/hypertrophy) of the contralateral gland (if paired- ex: adrenal gland) is common

hormone

atrophy

nonfunctional proliferative lesions of endocrine organs do not secrete excess __________. Tissue may be _________ locally but contralateral gland (choose one: does/does not) atrophy

hormone

destroyed

Does not

T/F whether functional or not, large lesions in endocrine organs can destroy the rest of the gland and cause deficiencies in hormones secreted by other populations of cells

True

what secondary changes can lead to diffuse atrophy of endocrine organs? (4)

secondary to excess circulating hormone (feedback)

decreased stimulatory hormone/substance

autoimmune/toxic destruction

defective receptors

what secondary changes can lead to diffuse hyperplasia of endocrine organs?

secondary to excess stimulatory substance/hormone or mimic

___________: a developmental disorder where the tissue/structure is never formed

aplasia

___________: a developmental disorder where the tissue/structure is formed but small

hypoplasia

___________: a developmental disorder where the tissue/structure is formed incorrectly

dysplasia

are most cases of acute inflammation of endocrine organs a primary or secondary disease?

secondary

Most cases of acute inflammation of endocrine organs is secondary to what?

systemic disease (endotoxemia, septicemia) or local extension rather than primary infection

most cases of chronic inflammation of endocrine organs are secondary to what?

systemic disease with immune evading agents (fungal, MB) or autoimmune disease

Acute inflammatory lesions of endocrine organs are (choose one: suppurative/pyogranulomatous lymphoplasmacytic)

suppurative

Chronic inflammatory lesions of endocrine organs are (choose one: suppurative/pyogranulomatous lymphoplasmacytic)

pyogranulomatous lymphoplasmacytic