250b Endocrine Cancers Flashcards
thyroid cancer treatment (first aid)
Thyroidectomy is treatment option for thyroid cancers and hyperthyroidism.
Complications of surgery include hoarseness (due to recurrent laryngeal nerve damage), hypocalcemia (due to removal of parathyroid glands), and transection of inferior thyroid artery.
Papillary carcinoma of thyroid
follicular cells
Most common, excellent prognosis.
Empty-appearing nuclei (“Orphan Annie” eyes) psammoma bodies, nuclear grooves.
increased risk with (MAP Kinase) RET and BRAF mutations, childhood irradiation.
follicular carcinoma of the thyroid
follicular cells
Good prognosis, invades thyroid capsule (unlike follicular adenoma), uniform follicles.
medullary carcinoma of the thyroid
parafollicular “C cells”
produces calcitonin, sheets of cells in an amyloid stroma.
Associated with MEN 2A and 2B (RET mutations).
Undifferentiated/anaplastic carcinoma of thyroid
Older patients; invades local structures, very poor prognosis.
Lymphoma of the thyroid
Associated with Hashimoto thyroiditis.
thyroid gland histo
follicular cells (make TG via TPO) surrounding colloid
NIS moves I across BM
Pendrin - moves I into colloid
Thyroid embryology
outpouching of pharynx at foramen cecum–>
remnants are thyroglossal duct and pyramidal lobe
tissue can be found along the migratory pathway
what test shoul dbe used for thyroid nodules?
TSH - people with cancer have a normal level, but people with high TSH have a higher likelihood of cancer
risk factors for thyroid cancer?
family history
radiation at young age
history of high TSH
what cancer does radioiodine not kill? what cancers does it kill?
medullary thyroid cancer
anaplastic cancer
requires NIS (PTC, FTC, HCC)
embryology of PTH glands
upper - brachial arch IV
lower - brachial arch III (w/ thymus)
what makes PTH? other cells? what causes increased secretion of PTH?
chiefs cells
oxyphil cell - unknown fxn
low Ca
hypercalcemia tests
check PTH
high = hyperparathyroidism (1=autonomous PTH, 2=external PTH, 3=continued hyper PTH after treatment)
low = something else (cancer)
presentation of hyperPTH?
renal Stones painful Bones abdominal Groans psychogenic Moans fatigue Overtones
