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The Thyroid Gland

The Thyroid Gland

The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...

Hyperthyroidism II: Pathophysiology

Hyperthyroidism II: Pathophysiology

Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...

Hyperthyroidism I: Introduction

Hyperthyroidism I: Introduction

Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...

Graves Disease II: Pathophysiology

Graves Disease II: Pathophysiology

Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor, and heat...

Synthesis and Regulation of Thyroid Hormones

Synthesis and Regulation of Thyroid Hormones

Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The iodine is then...

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Related Experiment Video

Updated: May 23, 2026

Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration

Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration

Published on: November 10, 2014

Thyroid fine needle aspirate: a post-Bethesda update.

Shikha Bose¹, Ann E Walts

¹Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA. boses@cshs.org

Advances in Anatomic Pathology

|April 14, 2012

Summary

The Bethesda system for thyroid cytopathology reporting needs improvement. Morphologic and molecular studies are underway to address variability in follicular lesion, neoplasm, and suspicious categories for better thyroid nodule diagnosis.

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Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration

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Published on: November 28, 2025

Area of Science:

Cytopathology
Endocrinology
Oncology

Background:

The 2007 Bethesda system for thyroid cytopathology reporting standardized specimen analysis and management.
However, categories like "follicular lesion of undetermined significance" and "follicular neoplasm" exhibit significant interobserver variability.
Uncertainty in these classifications complicates patient management algorithms.

Purpose of the Study:

To summarize recent and ongoing research aimed at resolving diagnostic ambiguities in thyroid cytopathology.
To highlight advancements in morphologic and molecular studies for improved thyroid nodule classification.

Main Methods:

Review of current literature on thyroid cytopathology.
Analysis of recent morphologic studies.
Summary of ongoing molecular investigations.

Main Results:

Identified persistent interobserver variability in specific Bethesda system categories.
Highlighted the potential of novel morphologic and molecular markers to improve diagnostic accuracy.
Indicated progress in developing more definitive diagnostic criteria.

Conclusions:

Further research, particularly in morphologic and molecular diagnostics, is crucial for refining the Bethesda system.
Improved classification of follicular lesions and neoplasms will enhance patient management and reduce diagnostic uncertainty.
Ongoing studies show promise in standardizing the interpretation of challenging thyroid cytology cases.