Page 729 - Robbins Basic Pathology by Vinay Kumar, Abul K. Abbas, Jon C. Aster

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Endocrine System 19studentconsult.com

CHAPTER CONTENTS

PITUITARY 716 Neoplasms of the Thyroid 728 ADRENAL CORTEX 752
Hyperpituitarism and Pituitary Adenomas 729 Adrenocortical Hyperfunction
Adenomas 717 (Hyperadrenalism) 752
Prolactinomas 719 Carcinomas 730 Hypercortisolism and Cushing
PARATHYROID GLANDS 735 Syndrome 752
Growth Hormone–Producing (Somatotroph Hyperparathyroidism 735
Cell) Adenomas 719 Primary Hyperparathyroidism 736 Hyperaldosteronism 755

Adrenocorticotropic Hormone–Producing Secondary Hyperparathyroidism 738 Adrenogenital Syndromes 756
(Corticotroph Cell) Adenomas 719 Hypoparathyroidism 738 Adrenal Insufficiency 757
ENDOCRINE PANCREAS 739 Acute Adrenocortical Insufficiency 757
Other Anterior Pituitary Neoplasms 720 Diabetes Mellitus 739
Hypopituitarism 720 Diagnosis 739 Chronic Adrenocortical Insufficiency:
Posterior Pituitary Syndromes 721 Addison Disease 757
THYROID 721 Classification 739
Hyperthyroidism 722 Secondary Adrenocortical Insufficiency 758
Hypothyroidism 723 Normal Insulin Physiology and Glucose Adrenocortical Neoplasms 759
Thyroiditis 724 Homeostasis 739 ADRENAL MEDULLA 760
Chronic Lymphocytic (Hashimoto) Tumors of the Adrenal Medulla 760
Thyroiditis 724 Insulin Resistance 741 Pheochromocytoma 760

Subacute Granulomatous (de Quervain) Beta Cell Dysfunction 743 Neuroblastoma and Other Neuronal
Thyroiditis 725 Neoplasms 761
Monogenic Forms of Diabetes 743
Subacute Lymphocytic Thyroiditis 726 MULTIPLE ENDOCRINE
Complications of Diabetes 743 NEOPLASIA SYNDROMES 761
Other Forms of Thyroiditis 726 Pancreatic Neuroendocrine Multiple Endocrine Neoplasia Type 1 761
Graves Disease 726 Tumors 751
Diffuse and Multinodular Goiter 728 Insulinomas 751 Multiple Endocrine Neoplasia Type 2 762

Gastrinomas 752

The endocrine system is a highly integrated and widely is composed of two groups: (1) peptide hormones,
distributed group of organs that orchestrate a state of meta- such as growth hormone and insulin, and (2) small mole-
bolic equilibrium, or homeostasis, among the various cules, such as epinephrine. Binding of these hormones
tissues of the body. Signaling by extracellular secreted mol- to cell surface receptors leads to an increase in intracel-
ecules can be classified as one of three types—autocrine, lular molecules, termed second messengers, such as
paracrine, or endocrine—according to the distance over cyclic adenosine monophosphate (cAMP); production of
which the signal acts (Chapter 2). In endocrine signaling, the mediators from membrane phospholipids (e.g., inositol
secreted molecules, which frequently are called hormones, 1,4,5-trisphosphate); and shifts in intracellular levels of
act on target cells distant from their site of synthesis. An ionized calcium. Elevated levels of one or more of these
endocrine hormone typically is carried by the blood from compounds can change proliferation, differentiation,
its site of release to its target. Increased activity of the target survival, and functional activity of cells, mainly by regu-
tissue often downregulates the activity of the gland that lating the expression of specific genes.
secretes the stimulating hormone, a process known as feed- • Hormones that diffuse across the plasma membrane and inter-
back inhibition. act with intracellular receptors: Many lipid-soluble hor-
mones pass through the plasma membrane by diffusion
Hormones can be classified into several broad catego- to interact with receptors in the cytosol or the nucleus.
ries, based on the nature of their receptors: The resulting hormone-receptor complexes bind specifi-
• Hormones that trigger biochemical signals upon interacting cally to promoter and enhancer elements in DNA,

with cell surface receptors: This large class of compounds