Amboss thyroid ca

Question 1

40–60 years of age
Well differentiated
Hematogenous metastasis especially to Bone (lytic lesions)
Vascular and capsular invasion
Good prognosis

Answer 1

Follicular thyroid carcinoma

Question 2

30–50 years of age
Well differentiated
Most common type of thyroid cancer
Palpable lymph nodes due to metastatic spread (often detected before primary tumor

Very good prognosis

Answer 2

Papillary thyroid carcinoma

Question 3

After 60 years of age
Rapid local growth
Symptoms of compression of the structures of the neck (e.g. dysphagia, dyspnea)
Lymphatic and hematogenous metastasis
Poorly differentiated
Very poor prognosis

Answer 3

Anaplastic thyroid carcinoma

Question 4

50–60 years of age
Sometimes a genetic predisposition → multiple endocrine neoplasia type 2 (MEN2)
Produces calcitonin
Diarrhea and facial flushing

Answer 4

Medullary carcinoma

Question 5

Painless cervical lymphadenopathy

Answer 5

More common in papillary thyroid cancer and anaplastic thyroid cancer
Less common in follicular thyroid cancer

Question 6

Signs of distant metastasis

Answer 6

More common in follicular thyroid cancer and anaplastic thyroid cancer
Less common in papillary thyroid cancer

Question 7

Paraneoplastic syndrome

Answer 7

: diarrhea and facial flushing (typically seen in advanced medullary carcinoma) [8]

Question 8

Medullary carcinoma thyroid cancer tumor markers

Answer 8

Calcitonin: A hormone secreted by parafollicular cells, which is the tissue of origin of medullary carcinoma

Question 9

Psammoma bodies is seen in ____________

Answer 9

Morphology: concentric lamellar calcifications
Occurrence: seen in diseases associated with calcific degeneration
Papillary thyroid carcinomas (evidence of psammoma bodies in thyroid tissue should always raise suspicion of malignancy)
Serous papillary cystadenocarcinoma of ovary and endometrium
Meningiomas
Mesotheliomas

Question 10

“Orphan Annie” eyes nuclei
Morphology: empty-appearing large oval nuclei with central clearing
Occurrence
Papillary thyroid carcinomas
Autoimmune thyroiditis (e.g., Hashimoto disease, Grave disease)
Nuclear grooves

Answer 10

Papillary thyroid cancer

Question 11

Follicular carcinoma histo

Answer 11

Uniform follicles; vascular and or capsular invasion

Question 12

Medullary carcinoma histo

Answer 12

Ovoid cells of C cell origin and therefore without follicle development
Amyloid in the stroma (stains with Congo red)

Question 13

Anaplastic thyroid carcinoma

Answer 13

Undifferentiated giant cell (i.e., osteoclast-like cell)
Areas of necrosis and hemorrhage

Question 14

Complications thyroid ca

Answer 14

Hypocalcemia
Dysphonia (hoarseness) and/or dysphagia:
Vocal cord function should be assessed preoperatively with laryngoscopy.

Question 15

Etiology Medullary carcinoma:

Answer 15

associated with MEN2 (RET gene mutations) or familial medullary carcinoma

Question 16

Etiology Papillary carcionma

Answer 16

Papillary carcinoma: associated with RET/PTC rearrangements and BRAF mutations

Ionizing radiation (particularly during childhood): mostly associated with papillary carcinoma

Question 17

Etiology Follicular carcinomaend

Answer 17

Follicular carcinoma: associated with PAX8-PPAR-γ rearrangement and RAS mutation

Question 18

Etiology Undifferentiated/anaplastic carcinoma:

Answer 18

Undifferentiated/anaplastic carcinoma: associated with TP53 mutation