Chapter 25: Endocrine Pathology

Endocrine Pathology review of endocrine pathology examines the etiology, pathogenesis, and clinical manifestations of hormonal disorders affecting the thyroid, parathyroid, pituitary, and adrenal glands, as well as the pancreas. The chapter begins by detailing thyroid dysfunctions, including the autoimmune mechanisms driving Graves disease (hyperthyroidism) and Hashimoto thyroiditis (hypothyroidism), while distinguishing between benign multinodular goiters and malignant neoplasms such as papillary, follicular, medullary, and anaplastic carcinomas. Discussion of the parathyroid glands focuses on calcium regulation, contrasting primary hyperparathyroidism caused by adenomas with secondary forms resulting from renal failure, and outlining the neuromuscular consequences of hypoparathyroidism found in conditions like DiGeorge syndrome. Pituitary pathology is explored through anterior lobe adenomas, such as prolactinomas and growth hormone-secreting tumors leading to acromegaly, alongside posterior lobe syndromes like central diabetes insipidus and SIADH which disrupt water balance. The text analyzes adrenal disorders by separating cortical pathologies—such as Cushing syndrome, Conn syndrome (hyperaldosteronism), and congenital adrenal hyperplasia—from medullary tumors like pheochromocytomas, while also covering acute and chronic adrenal insufficiencies seen in Waterhouse-Friderichsen syndrome and Addison disease. Furthermore, the chapter categorizes Multiple Endocrine Neoplasia (MEN) syndromes types 1, 2A, and 2B based on their genetic mutations and tumor associations. Finally, the summary elucidates the pathology of Diabetes Mellitus, differentiating the autoimmune beta-cell destruction of Type 1 from the insulin resistance of Type 2, and listing the systemic chronic complications including retinopathy, nephropathy, and neuropathy.