Endo: Thyroid Nodules Flashcards
Thyroid adenomas
- Benign or malignant?
- Solitary or multiple nodules?
- Typical histologic pattern?
Thyroid adenomas
- Benign neoplasm
- Solitary nodule
- Usually Follicular histology
What distinguishes thyroid adenoma from carcinoma?
Thyroid adenomas DO NOT invade the capsule or surrounding vessels
You see a solitary thyroid nodule without invasion of the capsule. What would you call it?
Is it likely to be secreting thyroid hormone?
- Thyroid adenoma
- Most adenomas are cold (do not secrete T3/4), but some can be hot (secrete T3/4 and cause hyperthyroidism)
Describe what you see.
![](https://s3.amazonaws.com/brainscape-prod/system/cm/261/434/225/q_image_thumb.png?1543975547)
Well-circumscribed, well-differentiated nodule next to normal thyroid follicles. Likely an adenoma.
Papillary thyroid carcinoma
- Common or rare?
- Prognosis?
- Solitary or multiple nodules?
- Typical spread?
Papillary thyroid carcinoma
- Very common
- Excellent prognosis
- Multifocal
- Lympathic invasion
A thyroid nodule exhibits empty-appearing nuclei with central clearing, and psammoma bodies.
Likely diagnosis?
Papillary carcinoma
*Papi and Moma adopted Orphan Annie (Papillary has psammoma bodies and orphan Annie nuclei)
Medullary carcinoma
- Origin?
- Secretions (3)
Medullary carcinoma
- Derived from C cells
- Secretions: calcitonin, chromogranin, amyloid (congo Red)
Lymphoma of the thyroid is most common in patients with __________
Lymphoma in the thyroid is most common in patients with Hashimoto’s thyroiditis
How do you evaluate a thyroid nodule? (3)
- TSH
- Neck ultrasound
- Fine needle aspiration
How can you evaluate a thyroid nodule that is indeterminant after FNA? (2)
- Ultrasound features
- Molecular markers
Follicular carcinoma
- Prognosis?
- Route of spread?
- Mutations?
Follicular carcinoma
- Good prognosis
- Invades the vasculature -> spreads by blood
- Associated with RAS and PAX8-PPARgamma mutations
Papillary carcinoma is associated with what mutations? (2)
- BRAF
- RET/PTC rearrangement
Name the feature seen here.
What type of thyroid nodule is it?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/261/436/255/q_image_thumb.png?1543975788)
Orphan Annie eyes! (empty nuclei with central clearing)
Typical of papillary carcinoma (Papi and Moma adopted Orphan Annie)
Which thyroid cancer is associated with MEN 2A/B?
Medullary thyroid carcinoma
What is the prognosis of anaplastic thyroid carcinoma?
Unlike the rest of thyroid carcinomas, anaplastic thyroid carcinoma has a very poor prognosis