Endocrine - thyroid neoplasia Flashcards
What is seen on an iodine radioactive uptake study in:
- graves
- nodular goiter
- adenoma
- carcinoma?
inc uptake in graves and nodular goiter
dec uptake in adenoma and carcinoma
What is seen pathologically in a follicular adenoma?
benign proliferation of follicles surrounded by a capsule
-hemorrhage and fibrosis are common
What is the most common type of thyroid carcinoma?
papillary carcinoma
What is a major risk factor for papillary carcinoma?
exposure to ionizing radiation in childhood
What is seen pathologically in a papillary carcinoma?
nuclear grooves, somoma body, ground glass nuclei
How do you determine if a follicular mass is an adenoma or carcinoma? What test is not useful for this?
invasion of the capsule
-fine needle aspiration
Where do follicular carcinomas like to metastasize?
hematogenously to bones of shoulder, pelvis, sternum, skull
What mutation is responsible for a follicular carcinoma?
RAS oncogene or rearrangement of PAX8
What cells are involved in a medullary carcinoma?
parafollicular C cells
What is seen clinically with a medullary carcinoma?
hyperPTH, hypocalcemia, episodic htn
What is present in MEN2A?
medullary carcinoma, pheo, parathyroid adenoma
What is present in MEN2B?
medullary carcinoma, pheo, gangliomas of oral mucosa
What do the cells of a medullary carcinoma tend to express?
CEA
What is the appearance pathologically of a medullary carcinoma?
malignant cells in an amyloid stroma
What is an anaplastic carcinoma of the thyroid?
undifferentiated malignant tumor
sarcoma like proliferation of bizarre spindle, and giant cells
