Chapter 21: Thyroid Neoplasms Flashcards
A thyroid nodule is found that is cold by radioiodine scan in a euthyroid patient. The mass is circumscribed with a thin fibrous capsule and has a follicular appearance. What is it?
Follicular adenoma of the thyroid.
Six subtypes - Embryonal, fetal, simple, colloid, hurthle, and atypical.
A circumscribed thyroid nodule is found in a euthyroid patient that is cold to radioactive iodine. It looks like this. What subtype is it?
Colloid adenoma - large follicles with excess colloid. A subtype of follicular adenoma.
A circumscribed thyroid nodule is found in a euthyroid patient that is cold to radioactive iodine. It looks like this. What subtype is it?
Embryonal adenoma.
A circumscribed thyroid nodule is found in a euthyroid patient that is cold to radioactive iodine. It looks like this. What subtype is it?
Fetal adenoma - small amounts of colloid, moreso than embryonal.
A circumscribed thyroid nodule is found in a euthyroid patient that is cold to radioactive iodine. It looks like this. What subtype is it?
Hurthle adenoma
A thyroid mass is found that is a solitary, well-circumscribed lesion. Histology is taken and shows variably sized papillae lined with cuboidal cells with dense and dispersed chromatin.
Papillary hyperplastic nodules (precursor to papillary carcinoma).
A painless, palpable thyroid nodule is discovered.
Histology shows mixerd papillary and follicular structures.
Nuclear atypia shows groundglass “Orphan Annie” nuclei, eosinophilic pseudoinclusions, and Psammoma bodies.
It looks like this. What is it?
Papillary thyroid carcinoma.
Patient presents with a hot thyroid nodule. On biopsy, the nodule is growing through the capsule.
It looks like this. What is it?
Follicular carcinoma of the thyroid
Patient presents with a firm thyroid nodule or cervical lymphadenopathy.
On histology, no capsule, stromal amyloid deposits, polygonal granular cells.
What is it? What serum marker might be elevated
Medullary Thyroid Carcinoma.
Secrets calcitonin.
May also secrete ACTH -> Cushings. Or VIP -> diarrhea.
Beware apple-green birefringence under congo red - procalcitonin forms amyloid deposits.
Associated with MEN2 and RET mutation.
A rapidly enlarging thyroid mass is found in a patient.
On histology, bizarre spindle giant cells with polyploid nuclei, many mitoses, necrosis, stromal fibrosis. Stains for cytokeratin and epithelial membrane antigen.
Anaplastic/undifferentiated thyroid carcinoma.
p53 mutation common. Poor prognosis.
Patient presents with a thyroid mass that looks like this. What is it?
Anaplastic carcinoma of the thyroid.
