Dyshormonogenetic Goiter Pathology

Abstract

Dyshormonogenetic goiter (DG) presents a pathological picture characterized by many solid nodular lesions with different patterns, a peculiar appearance of the surrounding nonnodular thyroid tissue, and the presence of features suspicious for carcinoma. Such features are caused by a high serum level of TSH (thyroid-stimulating hormone) in response to defects in the production of the thyroid hormone. The pathophysiology of DG is described, with regard to the hyperplastic and oncogenetic mechanisms attributed to TSH. The various histopathological features are reviewed, in particular those that help in differentiating the hypercellular nodules of DG from differentiated thyroid carcinoma. The literature on the histopathology of DG is reviewed and clues to avoid inappropriate overdiagnosis of malignancy are given.