Diffuse papillary hyperplasia of the thyroid gland

by Jason Wasserman MD PhD FRCPC
March 26, 2024

Diffuse papillary hyperplasia of the thyroid gland means an increase in both the size and the number of cells in the thyroid gland. The term diffuse means that the changes are seen throughout the entire thyroid gland while the term papillary is used to describe small finger-like projections of tissue that are commonly seen in this condition. It is a non-cancerous condition typically seen in people with Graves disease.

What causes diffuse papillary hyperplasia in the thyroid gland?

Diffuse papillary hyperplasia of the thyroid gland is caused by an autoimmune condition called Grave’s disease. In Grave’s disease, the immune system produces autoantibodies (antibodies directed at tissue normally found in the body) that activate a protein called thyroid stimulating hormone receptor (TSHR). TSHR is found on specialized follicular cells in the thyroid gland and when activated, stimulates the cells to produce thyroid hormone. The constant stimulation causes the thyroid gland to enlarge and produce abnormally high levels of thyroid hormone.

What are the symptoms of diffuse papillary thyroid hyperplasia of the thyroid gland?

Patients with diffuse papillary hyperplasia of the thyroid gland typically experience a condition called hyperthyroidism. In hyperthyroidism, the thyroid gland produces too much thyroid hormone. Symptoms of excess thyroid hormone production include nervousness, anxiety, shaking, fatigue, increased sweating, palpitations, and weight loss.

How is this condition diagnosed?

The diagnosis of diffuse papillary hyperplasia is typically made after the entire thyroid gland has been surgically removed and sent to a pathologist for examination under the microscope.

Diffuse papillary hyperplasia of the thyroid gland
Diffuse papillary hyperplasia of the thyroid gland. This picture shows multiple papillary projections lined by follicular thyroid cells.

What does it mean if representative sections were examined?

The term ‘representative sections’ means that only some parts of the thyroid gland were placed on glass slides and examined under the microscope. Pathologists typically only examine representative sections when a patient has a history of Grave’s disease because the gland is very large and examining the entire gland rarely results in additional information that would change the diagnosis.

About this article

This article was written by doctors to help you read and understand your pathology report. Contact us if you have any questions about this article or your pathology report. Read this article for a more general introduction to the parts of a typical pathology report.

Other helpful resources

American Thyroid Association
Atlas of pathology
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