NBME 23 Replacement of thyroid parenchyma by lymphoid cells (NBME Answers)

need help with your account or subscription? click here to email us (or see the contact page)

search for anything ⋅ score predictor (“predict me!”)

NBME 23 Answers

nbme23/Block 2/Question#20 (reveal difficulty score)
A 47-year-old woman has had a goiter for 10 ...
Replacement of thyroid parenchyma by lymphoid cells 🔍 / 📺 / 🌳 / 📖
tags:

+7 upvote downvote
submitted by ∗notadoctor(175)

get full access to all content ⋅ pick a username

Remember on histology Hashimoto's thyroiditis has two distinct features Hürthle cells(which are eosinophilic metaplastic cells that line follicles) and lymphoid aggregates with germinal centers.(pg. 338, FA 2019) The correct answer describes the latter feature of Hashimoto's.

get full access to all content ⋅ pick a username

+1 upvote downvote
submitted by ∗chris07(69)

get full access to all content ⋅ pick a username

I'm guessing that since this is hashimoto's that a biopsy of the thyroid would show the thyroid gland completely engulfed by attacking lymphocytes. Over time though, wouldn't the thyroid be completely destroyed and fibrotic?

get full access to all content ⋅ pick a username

dr.xx Progressive thyroid cell damage can change the apparent clinical picture from goitrous hypothyroidism to that of primary hypothyroidism, or "atrophic" thyroiditis. https://www.ncbi.nlm.nih.gov/books/NBK285557/ The pathological features are atrophic thyroid gland with lymphocytic infiltration and fibrous tissue replacing normal thyroid parenchyma. https://www.researchgate.net/publication/302196286_Atrophic_Thyroiditis +

paulkarr I was thinking that "Diffuse fibrosis" was trying to point to IgG4 Riedel Thyroiditis rather than Hashimoto's. +8

spow It's only been 10 months, per the question stem. This probably isn't long enough for fibrosis to be correct +2

Must-See Comments from nbme23

ferrero on Precapillary resistance
yotsubato on 99%
sne on Triglyceride
sajaqua1 on Area labeled ‘D’ (Spinothalamic tract, right)
stinkysulfaeggs on Hypoglycemia
hayayah on Iris
soph on Peak inspiratory pressure (alveolar): ...
seagull on Area labeled ‘C’ (Cranial nerve 8: ...
water on Dietary change
wired-in on 28.8
beeip on Binding of permeable ligand to nuclear ...
thomasalterman on Hypoglycemia
yotsubato on Inhibition of the cytochrome P450-dependent ...
seagull on Decreased sodium bicarbonate reabsorption in ...