The diagnostic evaluation and management of hyperthyroidism due to Graves’ disease, toxic nodules, and toxic multinodular goiter
David S. Cooper, Jennifer A. Sipos in Medical Management of Thyroid Disease, 2018
Histologically, autonomous nodules are cellular follicular lesions with frequent hemorrhage, fibrosis, calcification, and cysts. There is a dense fibrous capsule. The vast majority of solitary autonomous thyroid nodules are benign. In adults, as many as several percent of these nodules contain foci of papillary thyroid cancer, whereas in children and adolescents, the percentage of autonomous nodules that contain thyroid cancer is likely higher (e.g., 233). A fine needle aspiration biopsy of the nodule should be performed if there is any suspicion of cancer based on clinical, historical, sonographic, or laboratory studies. For example, the presence of associated cervical lymphadenopathy, recent growth (which could simply represent hemorrhage), or a history of neck radiation may increase the suspicion for associated cancer. The type of thyroid cancer found in this circumstance is usually papillary thyroid cancer, although other types, such as follicular or Hürthle cell cancer (234) may be identified. Earlier studies suggested that cytologists would read aspirates from autonomous nodules as suspicious for follicular thyroid cancer, given the cellular nature of these nodules. However, subsequent analyses show that the fine needle aspirations are rarely confusing and that the majority of autonomous nodules yield benign cells in the presence of colloid.
Coronary artery disease
Swati Gupta, Alexandra Marsh, David Dunleavy, Kevin Channer in Cardiology and the Cardiovascular System on the move, 2015
Advanced lesion: atherosclerotic plaqueTwo components (see Figure 3.2):Atheroma: soft inner core composed of lipids and a periphery of necrotic foam cells and cholesterol crystals – highly thrombogenic in nature.Fibrous capsule: outer layer composed of smooth muscle cells that have migrated from the media into the intima sequestering the lipid core – may start to calcify.Plaques become problematic: In angina, increased luminal obstruction will result in a mismatch between O2 delivery in situations of increased demand such as during exercise (usually the stenosis has to be >50% of the arterial lumen diameter [75% cross-sectional area] for symptoms to appear).In acute myocardial infarction, the fibrous capsule erodes or ruptures, exposing the lipid core to the blood and resulting in thrombus formation and distal embolization.
The Urinary System and Its Disorders
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss in Understanding Medical Terms, 2020
Although the hilum appears to be a deep indentation in the smooth, fibrous capsule covering the kidney, a cross-sectional examination reveals that it actually reaches deep into the center and forms a cavity called the renal sinus. The renal sinus is filled with fat and provides the bed for the renal vessels and nerves as well as the ureter. Within the renal sinus, the ureter expands into a funnel-shaped structure, the renal pelvis, from which reach tubular projections called the majorcalyces (singular: calyx, named for the Greek word kalyx, the cup of a flower, like which it is shaped). The major calyces reach toward the glandular part of the kidney, and each divides into several minor calyces. Together, the calyces and renal pelvis form the drainage system for urine in its path from the glandular part of the kidney, where it is formed, to the ureter.
Early histological and ultrastructural changes in expanded murine scalp
Published in Ultrastructural Pathology, 2020
Zhou Yu, Shiqiang Liu, Jiangbo Cui, Yajuan Song, Tong Wang, Baoqiang Song, Pai Peng, Xianjie Ma
Compared with that in the control group, the thickness of the subcutaneous adipose tissues and muscles in groups I and II was reduced (Figure 2b,d,f,j and k). Histological staining revealed the disappearance of large amounts of adipose tissue and muscle. The remaining adipose tissue and muscle did not display any significant histopathological changes (Figure 2b,d). Besides, a fibrous capsule composed of collagens and fibroblasts was detected in both the expanded groups. The cytoplasm of the fibroblasts and collagens was oriented parallel to the tissue expander (Figure 2b,d). Occasionally, a few inflammatory cells and extravasated red blood cells were observed in the fibrous capsules. No signs of necrosis were detected in the expanded scalps. Interestingly, similar histological changes were observed in both expanded groups. No statistically significant differences in the thickness of distinct scalp layers were detected between groups I and II (Figure 2g–l).
Histopathological evaluation of the effect of hyperbaric oxygen therapy on capsule occurrence around silicone breast prosthesis: an experimental study
Published in Journal of Plastic Surgery and Hand Surgery, 2021
Serhat Yarar, Abdullah Arslan, Bilsev Ince, Mehmet Emin Cem Yildirim, Pembe Oltulu, Ilker Uyar, Mehmet Dadaci
Silicone breast prostheses are being used more commonly in breast reconstruction after breast augmentation or mastectomy. In general, capsular contracture is the underlying cause of complications such as pain, stiffening, breast asymmetry, and animation deformity that are seen in the late postoperative period because of the use of silicone breast prostheses [1]. It is a known fact that after foreign bodies are inserted into the body, capsule reaction occurs around them over time. There are many mechanisms and theories in the literature which were revealed about the process of capsule reaction. The most common theory of capsular reaction is a foreign body reaction which is a natural tissue response. Macrophages, T cells, and a variety of cytokines accumulate around a foreign body (implant) as an immune response. Then, the number of proinflammatory cells decreases, and the number of fibroblasts increases around the implant. Thus, a fibrous capsule occurs [2].
Drug delivery targets and systems for targeted treatment of rheumatoid arthritis
Published in Journal of Drug Targeting, 2018
Xun Feng, Yang Chen
As shown in Figure 1, the synovial joint is composed of two articulating bones which are capped by avascular cartilages. To maintain its structural integrity, the joint is enclosed by a fibrous capsule and accessory ligaments. Within this structure lies a thin sheet of tissue called synovium (also known as synovial membrane) [6–8]. The synovium generates the synovial fluid (SF), which acts as a lubricant in the joint cavity and supplies with oxygen and nutrients to the cartilage via its rich microcirculation. In RA, a plethora of inflammatory cells infiltrate the synovium and most frequently found cell types include T cells, dendritic cells, macrophages, fibroblasts, mast cells, neutrophils and B cells. The endothelial cells express adhesion molecules that also promote the recruitment of these inflammatory cells into the joint. The activated inflammatory cells provoke the release of pro-inflammatory cytokines, including interleukins (ILs) and tumour necrosis factors (TNFs), as well as the secretion of matrix metallproteinases and prostaglands. The cytokines further stimulate the recruitment of the inflammatory cells from blood to the rheumatoid joint, resulting in the inflammation of the synovial tissues. By contrast, the matrix metalloproteinases and prostaglands secreted into the synovial fluid lead to the degradation of cartilage and bones. In addition, the activated inflammatory cells, as well as their products, can also stimulate the angiogenesis within the tissue. As a consequence, the synovial lining in RA joints becomes hypertrophic, with an increased synovial fluid volume, as well as acidosis and hypoxia [9].
Related Knowledge Centers
- Anatomy
- Bone
- Dense Connective Tissue
- Synovial Joint
- Synovial Membrane
- Shoulder
- Adhesive Capsulitis of The Shoulder
- Plica Syndrome
- Capsule of The Glenohumeral Joint
- Articular Capsule of The Knee Joint