复旦大学：《病理学 Pathology》课程英文PPT课件_Chapter XIII Diseases of Endocrine System

Diseases of Endocrine System Zeng Wenjiao 曾文姣 wizen(@fudan.edu.cn Pathology Department, Shanghai Medical College, Fudan University 2012-12

Diseases of Endocrine System Zeng Wenjiao 曾文姣 wjzeng@fudan.edu.cn Pathology Department,Shanghai Medical College,Fudan University 2012-12

corpus pineale 松果体 Pituitary垂体 颁动脉小球 Glomus caroticum thyroid甲状腺 Hormones Thymus胸腺 Pericardium 主动脉腹部腹主动脉 Pars abdominalis aortae Adrenals肾上腺 Metabolic 皮质 equilibrium slet of pancreas胰岛 /homeostasis 主动脉旁体 Corpora para.aortica 扬系模下动脉 . A mesenterica inferior Ovary卵巢 Testis睾丸

corpus pineale 松果体 Pituitary 垂体 thyroid 甲状腺 Thymus 胸腺 Adrenals 肾上腺 islet of pancreas 胰岛 Testis 睾丸 Ovary 卵巢 Hormones Metabolic equilibrium /homeostasis

Classification 1. Diseases of under/over-production of hormones and their resultant biochemical and clinical consequences 2. Diseases associated with the development of mass lesions morphologic findings hormone level regulator metabolites

Classification 1. Diseases of under/over-production of hormones and their resultant biochemical and clinical consequences 2. Diseases associated with the development of mass lesions. morphologic findings hormone level regulator metabolites

Excess Insufficiency adrenal cortisol Cushing syndrome Addison disease aldosterone hyperaldosteronism 原发性醛固醇增多症 slet of insulin胰岛素 hypoglycemia低血糖 diabetes me|tus pancreas 糖尿病 thyroid thyroxine(T4) hyperthyroidism hypothyroidism triiodothyronine甲亢 甲减 3 cretinism呆小病 pituitary growth hormone gigantism巨人症 dwarfism侏儒症 acromegaly 肢端肥大症

Excess Insufficiency adrenal cortisol aldosterone … Cushing syndrome hyperaldosteronism 原发性醛固醇增多症 Addison disease islet of pancreas insulin 胰岛素 … hypoglycemia 低血糖 diabetes mellitus 糖尿病 thyroid thyroxine (T4) triiodothyronine (T3) hyperthyroidism 甲亢 hypothyroidism 甲减 cretinism 呆小病 pituitary growth hormone … gigantism 巨人症 acromegaly 肢端肥大症 dwarfism 侏儒症

Pituitary adenoma Growth Hormone prepubertal children before epiphyses close gigantism

Pituitary adenoma Growth Hormone gigantism prepubertal children before epiphyses close

Adults 1941年 1949年 1956年 肢端肥大症 (由1941年的正常面容,逐渐转变为1956年的曲型肺端肥大症而容) acromegaly soft tissues 满肥大症 skin VIscera bones of the face hands and feet

acromegaly soft tissues skin viscera bones of the face, hands and feet Adults

Thyroid 甲状软骨 甲状腺 气管 胸骨 锁骨

Thyroid

ypothalamus-pituitary-thyroid axis TRH: thyrotropin-releasing hormone TRH TSH thyroid-stimulating hormone TSH Pituitary TSH receptor T4: thyroxine Th id GG protein homone T3: triiodothyronine T3, T receptor GTP G void Target The net effect of t4 t3 tcAMP on t basal metabolic rate (BMR) Gene expression on

hypothalamus-pituitary-thyroid axis The net effect of T4 T3 :  basal metabolic rate (BMR) TRH: thyrotropin-releasing hormone TSH: thyroid-stimulating hormone T4: thyroxine T3: triiodothyronine

Th ly1 rolc d ■ Follicles ° epithelium thyroglobulin-rich colloid Normal follicular cells

Thyroid ◼ Follicles • epithelium • thyroglobulin-rich colloid Normal follicular cells

Synthesis and storage of thyroid hormones a Thyroglobulin iodination Olloid-77 A 6. Iodination, Storage.Co Thyroglobulin reabsorption 2. Uptake of 5. Secretion iodination stored ☆ Thyroglobulin Digestion by Lysosomes lodide lysosomal s3.Endocytosis 4. Packaging lgi complex I ④ vacuoles Merge with 3b. Oxidation vesicles bearing Mannose y vi/enzymes incorporation 4. Release of Protein 3. Synthesis Synthesis of T3 and T4 from synthesis aere lysosomal 器己部 enzymes TBG lodide transporter 5. Secretion of T3 and T4 2. AA, Iodide uptake Amino acids lodide 1. Stimulation by TSH Capillary lumen

Synthesis and Storage of thyroid hormones