Cause of toxic nodular goiter, toxic nodular goiter is caused by what the cause

toxic nodular goiter is caused by what the?

(a) causes

Plummer disease secondary to multiple nodular goiter, or thyroid tumors (high-functioning adenomas or toxic thyroid adenoma), hyperthyroidism accounts for about 10% to 30%.

currently unknown etiology may be long-standing thyroid nodules or adenomas, the occurrence of autonomous secretion dysfunction, sometimes more abrupt onset of hyperthyroidism due to increased intake of iodine, causing autonomous thyroid hormone secretion, resulting in a typical hyperthyroidism symptoms.

(B) the pathogenesis

1. pathogenesis of Plummer disease or follicular adenoma and adenomatous hyperplasia of the disease showed hyperthyroidism, thyroid cells in some of the TSH, insulin-like growth factor (insulin-like growth factor), fibroblast growth factors (fibroblast growth factor) and other sensitive thyroid-stimulating material and nodular hyperplasia, follicular adenoma or develop into adenomatous hyperplasia, and thus self-discipline to produce thyroid hormone, causing hyperthyroidism, Plummer disease in iodine deficiency common areas, often in combination with endemic goiter also shows that the incidence of disease proliferation and TSH thyroid stimulating substances such as long-term chronic stimulation.

In addition, part of the Plummer disease, TSH receptor gene mutations are (somatic mutation), no such cases and because TSH stimulation continued to produce cAMP, resulting in self-regulation caused by excessive secretion of thyroid hormone disease, however, the Plummer disease, TSH receptor gene mutation frequency vary widely, from 0 to 80%.

2. pathologic enlargement of thyroid nodules (one or more), encapsulated or non-enveloped, microscope, nodular hyperplasia of follicular epithelium, a papillary formation, follicular fluid fewer glial and thin (which is the difference between simple goiter), adenomatous nodules also showed changes, nodules may have bleeding, calcification, nodules surrounding thyroid tissue shrinking and there is the phenomenon by squeezing .

immunohistochemical staining, tubercle of the follicular epithelium was T3, T4 strongly positive, while the surrounding epithelial cells were negative or weakly positive (Figure 2).

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electron microscopy findings: such as hyperthyroidism and Graves disease status of follicular epithelial cell morphology similar to that of cytoplasm, mitochondria, endoplasmic reticulum and Golgis body and other organelles increased.