What is the pathophysiology of goiter?

Answer 1

Pathophysiology

The histopathology varies with etiology and age of the goiter. Initially, uniform follicular epithelial hyperplasia (diffuse goiter) is present with an increase in thyroid mass. As the disorder persists, the thyroid architecture loses uniformity, with the development of areas of involution and fibrosis interspersed with areas of focal hyperplasia. This process results in multiple nodules (multinodular goiter). On nuclear scintigraphy, some nodules are hot, with high isotope uptake (autonomous) or cold, with low isotope uptake, compared with the normal thyroid tissue. The development of nodules correlates with the development of functional autonomy and reduction in thyroid-stimulating hormone (TSH) levels. Clinically, the natural history of a nontoxic goiter is growth, nodule production, and functional autonomy resulting in thyrotoxicosis in a minority of patients.

Signs / symptoms

dyspnea

stridor

Hemorrhage

bronchitis

dysphagia.

hoarseness.

facial plethora

and dilated neck veins

Answer 2

To understand the pathophysiology of goiter, first we must understand how the whole process of TSH works. TSH, also known as Thyroid Stimulating Hormone, is secreted by the anterior pituitary to the thyroid gland for it to be stimulated. Once TSH arrives the thyroid gland, it binds with thyroid cells receptors to be stored inside the thyroid gland. This, will enhance the production of iodine from the thyroid. Goiter is a disease divided into two categories: Non-toxic goiter and toxic goiter. Non-toxic goiter happens when the thyroid gland secretes INSUFFICIENT thyroid hormone to meet metabolic needs. When the thyroid gland cannot secrete enough hormone, it will work harder to meet metabolic demands of the body. This will cause the cells of the thyroid gland to overproduce, or hyperplasia. Hyperplasia of the thyroid gland causes enlargement of the thyroid gland. Toxic goiter happens when someone is exposed to non-toxic goiter for a prolonged time, normally happens to elderly people. The thyroid gland forms excess small rounded masses and secretes EXCESSIVE thyroid hormone.