Thyroid Diseases: Colloid goiter

Colloid goiter is a benign lesion of the thyroid gland which is defined as thyroid enlargement without accompanying disturbance in thyroid function. 

This is a common pathology, frequently found in clinical practice during a physical or ultrasound examination.

Therefore, the Colloid goiter of the thyroid is a benign growth. Nodular formations can be multiple or single instances. Formation is formed when the outflow of a colloidal substance from the follicles is disrupted. Thyroid hormones are produced in this liquid substance.

The tissue we see in the images is always recognizable, because there is nothing else in the body that looks like this. Follicles surrounded by an epithelial lining filled with protein material called colloid.

Fig 1. - Colloid goiter, Thyroid c.s. | Motic BA40E PlanApo 10X | 

Moticam S12, ROI | Image credit: Willem Cramer

Most normal thyroid glands have follicles that are fairly uniform in size with some variation. They don't get as big as some in the images. If the follicles are so enlarged by the colloid, you can speak of colloid goiter. What is the definition of the word goiter. This word is synonymous with an enlarged thyroid gland, enlarged for any reason. This does not automatically mean that the thyroid gland is overactive or neoplastic.

Fig 2. - Colloid goiter, Thyroid c.s. | Motic BA40E PlanApo 40X | 

Moticam S12, ROI | Image credit: Willem Cramer

If the affected thyroid can also be clinically associated with hyperthyroidism, which is an overproduction of thyroid hormones, then it could be a case of Graves' disease.

The photos show that the enlarged follicles are lined with relatively cube-shaped follicular or epithelial cells.

Sample: Colloid goiter, Thyroid c.s. Motic BA410E PlanApo 40X | Moticam S12 ROI. With thanks to Herbert Spoon, Doctor of Medicine.

Note: the prepared slide, a collector’s item, is 60 years old.

© willemsmicroscope.com

Digital Pathology and AI join forces

“Artificial intelligence” generated leukemia blast cells through pre-annotated digital images by using the Motic Infinity 60 at the Tan Tock Seng Hospital, Singapore.

This has enabled the creation of large image databanks of blood cells, allowing the exponential growth of artificial intelligence (AI) studies in blood cell classification.

Image 1. (A) Blood cells in myeloid leukemia stained with Ehrlich's triple stain, as seen under a microscope. Watercolor after A. Goodall, 1912. Wellcome Collection. https://wellcomecollection.org/works/dtfntjgs/images?id=h5k9mkax. (B and C) Leukemic blasts in the background of red cells. (Wright stain, 80× objective, Motic EasyScan Infinity 60). (D–F) Artificial Intelligence generated leukemic blasts and red blood cells using the StyleSwin generative adversarial network (GAN) algorithm. https://github.com/microsoft/StyleSwin.

A total of 21.739 pre-annotated digital images derived from peripheral blood films of patients with acute myeloid leukemia (Wright stain, 80x objective, MoticEasyScan Infinity 60) were used in the training and evaluation process. 

AI holds great promise in medicine due to its ability to effortlessly assimilate, integrate, and generate vast amounts of clinical data. However, AI needs suitable digital scanners for the digitalization of samples such as the Motic Infinity 60 of the MoticEasyScan series to facilitate the training tasks that will make its enhancement possible.

Read the article here

Kahler's disease

The disease owes its name to the Austrian doctor Otto Kahler, who described the disease as one of the first. Kahler's disease, also called multiple myeloma, is a disease of the bone marrow caused by an uncontrolled proliferation of a certain type of white blood cells: plasma cells (also called plasmocytes). Plasma cells are responsible for the formation of antibodies under normal conditions.

The bone marrow is a spongy substance located in the interior of bones, especially the pelvis, sternum, ribs and vertebrae. Bone marrow plays a role in forming bones, but also in forming the cells of the blood: white blood cells (leucocytes), red blood cells (erythrocytes) and platelets (thrombocytes). The disease develops in one abnormal plasma cell, which divides uncontrollably and whose offspring also divides uncontrollably. Since they are all related, they only synthesize one specific type of antibody (or part of it). Since antibodies are proteins, the antibody produced is referred to as the "M protein" (from Myeloma protein). The name paraprotein is also commonly used for the M protein. When a specific piece (called “light chain”) of a paraprotein is found in the urine (or blood serum), it is called the Bence-Jones protein.

Motic Path Case - Granulomatous disease of peritoneum

GRANULOMATOUS DISEASE OF PERITONEUM MIMICKING CLINICALLY A PERITONEAL CARCINOMATOSIS.

A 52 year-old woman, with a background of surgery by pelvic endometriosis two years before, was submitted for showing symptoms of abdominal distension with pseudo obstructive episodes and malaise. Apart from endometriosis, there was no a history of chronic inflammatory diseases or other interesting pathological events. At the physical exam, ascites is discovered coinciding with radiological study by abdominal scan (SC), which reveals multiple and heterogeneous nodules at the peritoneal surface. The clinical diagnosis was of peritoneal carcinomatosis. A laparoscopic study was realized in which no other abdominal abnormalities were perceived apart from the irregular peritoneal thickening, suggesting tumour process. Two biopsies of different nodules were made.  During histological exam, no neoformative tissue was found. On the contrary, the global alteration consisted of multiple isolated or confluent epithelioid granulomas in a fibrotic background. Basically they were made of histiocyte aggregates and less often multinucleated giant cells. Neither central necrosis nor characteristically morphological signs concerning to specific inflammatory disorders were seen. Specific stains such as Ziehl-Neelsen, Periodic Acid Schiff, Giemsa or Methenamine Silver did no visualized pathogen germs. In addition, in order to rule out tuberculosis, a PCR for BK bacilli was also negative. After the fact that specific aetiologies were discarded, the patient is being treated by anti-inflammatories and she is having a slow but good response.

Delimited by a narrow layer of fibrous tissue with mature lymphocytes.

Neither central caseous necrosis nor other specific histological characteristics are seen. 

Cutaneous Histiocytoma dog

Histiocytoma

A cutaneous histiocytoma is a benign skin tumor. It consists of an accumulation of a large amount of histiocytes in the skin. Histiocytes are cells that are involved in the immune system. We usually see histiocytomas in young dogs up to the age of 3 years.

In a short time there is a skin tumor ranging from a few millimeters to a few centimeters. Usually they are at the head, lips, ears, neck, legs and chest. They are not painful and do not cause itching, unless there is an inflammation. If they start to itch because of the inflammation, it means that the body is cleaning them up. Regularly this swelling looks fiery and choppy.

Mastocytoma dog

A mast cell tumor* (mastocytoma) is a potentially very malignant tumor of mast cells in the skin. This tumor is the most common skin tumor in dogs. It mainly occurs in the skin but not only there. A mast cell tumor can look very different. The tumor can be in the skin or under the skin. The presentation is usually like a solitary solid (sometimes soft) bump with a diameter of a few mm to as much as 10 cm. The overlaying skin is often alopecia (bald spot), erythematous (abnormal red), sometimes eroded or ulcerated (open wound). One should not squeeze the tumor; histamine granules* can be released (degranulate) This can cause an anaphylactic reaction, which means that the animal can get into shock. As mentioned, the tumor can be red in color, contain extra pigment or have the normal color of the skin.

As with all bumps on the skin, it is never possible to determine on the outside whether there is a tumor and what kind of tumor it is. Therefore, further investigation must also be carried out in the event of a suspicion of a mast cell tumor. This can be done by means of a FNAB (Fine Needle Aspiration Biopsy) or by means of a tissue biopsy. Cells are taken from the bump and these cells are assessed under the microscope (by a cytologist) as in this case. A FNAB gives a correct diagnosis in a large number of cases, but in all cases a tissue biopsy gives a correct and sometimes more extensive diagnosis.

Plasmacytoma dog

In the preparation shown here a biopsy taken from the skin of a seven-year-old Golden Retriever, many plasma cells can be seen. We also see anisocytosis and anisokaryosis. The coarse chromatin in the nucleus indicates that something may be wrong. Plasma cells are part of the immune system and are usually found in lymphatic tissue and mucosal surfaces. Plasma cells are immunoglobulin-producing cells that originate from B lymphocytes and are characterized in particular by a large amount of cytoplasm, an eccentrically located nucleus and a perinuclear optically empty court.

Allergic dermatitis in cats

When a cat comes into contact with an allergen, their body can react causing itching and inflammation. More severe cases of allergic dermatitis are easily recognized, while other may have very subtle signs and symptoms. That is why it is important to take a biopsy to make this sure and to investigate that it is not another ailment.

Case of ovarian cavernous hemangioma

Case report

A 46 year-old woman without any pathological background except multiple uterine leiomyomas was undergone to a total hysterectomy and bilateral adnexectomy. During study of surgical specimen, a little reddish nodule of 9 mm was discovered in the hilum of the left ovary. 

Microscopically, this nodule was made of dilated thin-walled vascular channels, filled of blood.

Image taken with a Moticam X3

Lick granuloma dog

A lick granuloma or acral lick dermatitis is a place on the skin as a result of frequent licking by the dog and is found usually at the end of the paws, hence acral (think of the Athenian Acropolis: city on top) Lesion is sharply defined. This is a nasty ailment. It is not always clear what causes it, but itching is often the reason. A physical cause is rarely found. Usually the cause is psychological such as boredom, separation anxiety, stress, nervousness or attention seeking behavior. Licking is then a distraction for the dog. Once the dog is licking, it is difficult to stop this. It has become a habit for the dog.

The first symptoms are discoloration of the coat due to the saliva. The skin can become thicker and bald. Inflammation of the skin is possible due to the granuloma. This starts itching more and makes the dog more lick and bite. Then the dog comes in a vicious circle. The process can continue down to the bone, sometimes amputation is necessary. A lick granuloma actually only occurs on the front legs.

Fibrosarcoma cat

A fibrosarcoma is a malignant tumor of mesenchymal connective tissue cells. Fibrosarcoma mainly occurs as a solitary tumor in the older cat. It can occur in several parts of the body. Usually on the trunk and often also between the shoulder blades, because injections are usually given here. First there is an injection site reaction that degenerates neoplastic. The rabies vaccine is known to be a possible cause of this. It is a malignant derailment of the dermal and subdermal connective tissue cells. The sarcoma grows locally very infiltratively and aggressively, not metastasizing quickly. But if so, then to the lungs and lymph nodes. Fibrosarcoma can also occur in young cats. In these cases it is often induced by a virus and there are multiple tumors over the entire body.

When bitten by a tick

Relapsing fever is bacterial infection characterized by recurring episodes of fever, headache, muscle and joint aches, and nausea. It is caused by certain species of Borrelia spirochetes. which are transmitted through the bites of lice or soft-bodied ticks.