ESR [021] Thyroid disease Flashcards by Moustafa Sharawy

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Figure illustrates 4 histological variations of Thyroid follicele appearance , define each one

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Thyroid tissue

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Thyroid tissue ;
Define the symbol and identify the stain used

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Thyroid tissue ;
Define the symbol and identify the stain used

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what” the thyroid pathology ?

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Thyroid microscopy ; describe an diagnose

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Multinodular thyroid goiter Gross picture ; describde

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Cross-section of a thyroid gland with multinodular goiter. Secondary changes such as hemorrhage and cystic degeneration can be seen. Some of the nodules (&raquo_space; ) are surrounded by an intact capsule.

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Pathological Thyroid microscopy ; define the abnormalities and diagnose

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Pathological Thyroid microscopy ; define the abnormalities and diagnose

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Multinodular goiter Clinical presentation ?

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• Markedly enlarged goiter

• Compression on trachea, esophagus (leading to dysphasia, stridor)

• Hyperfunction of thyroid gland (toxic multinodular goiter) with suppressed TSH +/- elevated free T4 or T3

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histological picture of Embryonal adenoma ?

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closely packed cells forming cords or trabeculae

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histological picture of Fetal adenoma ?

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small follicles containing no or little colloid separated by abundant loose connective tissue

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histological picture of Simple adenoma ?

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shows closely packed follicles of normal size

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histological picture of Colloid adenoma ?

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large follicles filled with colloid and lined by flat epithelium

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histological picture of Hürthle cell adenoma ?

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shows large granular cells with abundant eosinophilic cytoplasm arranged in trabecular pattern

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Hashimoto’s disease

Signs & symptoms

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Hashimoto’s thyroiditis is suspected

What are the tests needed?

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Gross picture indicating thyroid pathology ; describe and diagnose

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Thyroid microscopy ; identify symbols and diagnose + descibe

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Immunofluorescent of thyroid ; Diagnose

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Papillary thyroid carcinoma gender preferance ?

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Women > men (2.5:1)

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Papillary thyroid carcinoma age prevalance ?

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Peak incidence: 30-50y

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genes Associated with Papillary thyroid carcinoma ?

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Thyroid microscopy ; identify the charecteristic structure and diagno

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What are the characteristic nuclear features seen in the epithelial cells of a papillary carcinoma?

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Thyroid microscopy ; identify the charecteristic structure and diagno

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Thyroid microscopy ; describe and diagnose the pathology

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Micro-papillary carcinoma

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A thyroid carcinoma With Relatively benign course ?

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A thyroid carcinoma Associated with iodine deficiency ?

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Follicular thyroid carcinoma

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Peak age incidence of Follicular thyroid carcinoma ?

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40-60y

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How does Follicular thyroid carcinoma present ?

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Presents as enlarging solitary nodule or in the context of MNG

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Descrive metastatic activity of Follicular thyroid carcinoma

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Spread via bloodstream (metastasis in 50%)

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Survival rate of Follicular thyroid carcinoma ?

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Survival rate about 80% at 10 years, and decreasing according to the stage (50% for stage four)

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How to differentiate Follicular carcinoma than follicular adenoma Microscopicaly ?

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Follicular carcinoma

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Follicular carcinoma

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The ablation is conducted as a follow-up treatment following Thyroidectomy

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Medullary Carcinoma Microscopic picture ?

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Thyroid microscopy ; describe and diagnose

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Medullary carcinoma :

• Malignant cells may be round, polyhedral or spindle shaped

• Cells may form follicles, pseudo- papillary pattern or are arranged in sheets

• A homogenous pink, amyloid containing stroma is noted

• It can be visualized by Congo red stain

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Calcitonin

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above 60y

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Thyroid microscopy ; identify symbols and diagnose + descibe

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a type of hyroid imaging ; identify it

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Explain how Thyroid scintigraphy works

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Goal of thyroid Fine needle aspiration (FNA) ?

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• To diagnose thyroid neoplasms suitable for surgical resection

• To identify non- neoplastic lesions that may be managed conservatively

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The cytodiagnosis of thyroid nodules by FNA is complex.
WHY?

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a. Overlap of cytologic patterns between neoplastic and nonneoplastic lesions

b. Overlap of cytologic features between various neoplasms

c. Coexistence of non-neoplastic and neoplastic processes

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thyroid microscopy and FNA ; identify the structures and diagnose

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thyroid FNA and histology ; describe and diagnose

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thyroid FNA ; describe and diagnose

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