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Endocrine M2T2 > 9. Thyroid Neoplasms > Flashcards

9. Thyroid Neoplasms Flashcards

1
Q

What is a subtype of follicular adenomas? How do you tell?

A

Hurthle cell adenomas. Hurthle cells are eosinophilic cytoplasmic cells surrounding the follicles

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2
Q

What are the four types of thyroid carcinomas? Which is spread hemaogenously?

A

Follicular, papillary, medullary, anaplastic

Follicular ca is spread hemaogenously. All others are via lymphatics

N.B. Hemaogenous spread = sarcomas, lymphatic spread = carcinomas

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3
Q

What are the characteristics of papillary carcinomas?

A 
Most common type of thyroid ca
Well circumscribed and encapsulated
20-50s
Papillae
Orphan Annie nuclei
Psamomma bodies
Grooved nuclei
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4
Q

What are the genetic factors that lead to papillary ca?

A

RET, RAS, BRAF

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5
Q

What are the variants of papillary ca?

A

Follicular variant (not metastatic), tall cell variant (metastatic, elderly), diffuse; sclerosing (fibrosing), papillary microadenocarcinoma

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6
Q

What are the genetic factors that cause follicular ca?

A

RAS, PAX8 PPRG

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7
Q

What is the thyroid cancer with undifferentiated cells?

A

Anaplastic ca

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8
Q

Characteristics of anaplastic ca and symptoms

A 
Cytokeratin staining
Negative for thyroglobulin 
Very aggressive - almost everyone dies
Dyspnea, hoarseness, dysphasia, cough
Rapidly enlarging neck mass
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9
Q

Genetics of anaplastic ca

A

RAS, PI3K, PTEN

Inactivation of p53

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10
Q

Which cell type is effected in medullary ca? (Thyroid)

A

C cells Parafollicular

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11
Q

What do C cells produce

A

Calcitonin

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12
Q

Electron microscopy of medullary ca shows what?

A

Electron dense secretory granules

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13
Q

What substances do Medullary ca secrete?

A

Calcitonin, ACTH, serotonin

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14
Q

Clinical signs of medullary ca

A 
Low serum calcium levels
Neck mass (dysphagia, hoarseness)
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15
Q

Which thyroid ca is associated with MEN2 (2A, 2B)

What is MEN2. Differentiate 2a and 2b

A

Medullary ca

MEN2: medullary ca, pheochromocytoma

2A also has parathyroid adenomas
2B has ganglioneuroma of oral mucosa

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16
Q

What helps to differentiate follicular adenomas from follicular carcinomas?

A

Capsule present in both. In carcinoma, the tumor invaded through the capsule. Adenomas, entire tumor is encapsulated

17
Q

What hormones does medullary thyroid ca secrete?

A

Serotonin ACTH calcitonin

18
Q

Which disease is thyroid medullary ca associated with?

A

MEN2

19
Q

What hormones does medullary thyroid ca secrete?

A

Serotonin ACTH calcitonin

20
Q

Which disease is thyroid medullary ca associated with?

A

MEN2

Endocrine M2T2 (16 decks)

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