Thyroid tissue from a patient with untreated Graves disease is examined. Which combination best describes the expected microscopic appearance?

• A Scalloped colloid, tall columnar crowded follicular cells, and prominent lymphoid aggregates ✓
• B Dense colloid, flattened inactive epithelium, and extensive interfollicular fibrosis
• C Noncaseating granulomas with multinucleate giant cells within follicles
• D Oncocytic follicles with prominent nucleoli and scant colloid

Explanation

In Graves disease, TSH receptor stimulating antibodies drive diffuse follicular hyperplasia: the epithelium becomes tall columnar and crowded, and colloid is reduced with characteristic peripheral scalloping due to active resorption. A lymphocytic infiltrate is common. Option B describes the inactive gland or treated hypothyroid state, option C is subacute granulomatous (de Quervain) thyroiditis, and option D suggests oncocytic change seen in Hashimoto or Hürthle cell neoplasms.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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