2 - Pink Flashcards
After thorough H&P, what is the 1st step in the work-up of a thyroid nodule?
FNA
Nuclear imaging and US are reserved for more difficult cases
What are the various types of thyroid cancer?
Follicular Cell derived
- papillary - 80% of thyroid cancers / 92% 10yr survival
- follicular - 10% / 72%
- Hurthle cell - 1% / 70%
- anaplastic - 1-2% / <2%
C-Cell derived
- medullary - 3-5% / 30-50%
Lymphoma - 1% / 40-50%
Metastases - rare / varies
What are the risk factors for papillary thyroid cancer?
Radiation exposure
What are the risk factors for follicular thyroid cancer?
Radiation exposure
Iodine deficient goitre
Long-term iodine deficiency
What are the risk factors for Hurthle cell thyroid cancer?
Radiation
Family history
Lon
What are the risk factors for anaplastic thyroid cancer?
Long-standing goitre
Well-differentiated thyroid cancer
What are the risk factors for medullary thyroid cancer?
Genetic 20%
Sporadic 80%
What are the risk factors for lymphoma thyroid cancer?
Hashimoto’s Thyroiditis
What are the risk factors for metastatic thyroid cancer?
Previous carcinoma
Where clinical factors are involved in papillary thyroid cancer?
Younger onset Nodal spread (80%) Multi focal (>85%) Bone Mets (rare) Iodine sensitive
What clinical factors are involved in follicular thyroid cancer?
Older onset
Hematogenous spread
Bone mets occur
Iodine sensitive
What clinical factors are involved in Hurthle cell thyroid cancer?
Older onset
Hematogenous spread
Iodine resistant
What clinical factors are involved in anaplastic thyroid cancer?
Much older onset Local Nodal Hematogenous spread Iodine resistant Rapid growth
What clinical factors are involved in medullary thyroid cancer?
Nodal spread (65%)
Multifocal if genetic
Iodine resistant
What clinical factors are involved in lymphoma thyroid cancer?
Nodal spread
Sensitive to radiation
Sensitive to chemo
