Pathology: Thyroid and Parathyroid Neoplasms Flashcards
What do hot nodules indicate?
Growth is functional and almost certainly BENIGN
What do cold nodules indicate?
Growth is not functional and likely MALIGNANT
What do you do after a cold nodule shows up?
Call the surgeon, FNA possible too.
What is more likely in a single thyroid nodule?
Malignancy
What is more likely in multiple thyroid nodules?
Benign Goiter: rule out graves, hashimotos, etc…
How do you tell the difference between follicular adenoma and follicular carcinoma?
Invasion past capsule: impossible with FAN
TAKE IT OUT if it is an follicular lesion
What is the histology of a follicular lesion?
Uniform follicles producing colloid
Usually well capsulated, unless carcinoma
What are the general thyroid cancers of people under 40?
Papillary #1 (Psammoma bodies, lymphatic spread, previous ionizing radiation)
Follicular #2 (capsular invasion with follicles)
What are the general thyroid cancers of people over 40?
Medullary #1 (calcitonin, amyloid, hypocalcemia)
Anaplastic #2 (undifferentiated spindles, older patients)
Papillary carcinoma buzzwords?
MC thyroid cancer Previous ionizing radiation Calcification Psammoma bodies Cervical mets Lymphatic spread
Follicular carcinoma buzzwords?
Follicles with colloid
Capsular invasion
Medullary carcinoma?
Parafollicular cells overgrow Calcitonin Amyloid Hypocalcemia Anti-calcitonin staining Hematogenous spread
Anaplastic carcinoma buzzwords?
undifferentiated
older patients with previous thyroid cancer
100% mortality
giant, spindle, mixed cells
What branchial arch does thyroid develop from?
1 and 2 at foramen cecum
What embryologic layer is thyroid from?
Endodermal downgrowth of thyroid epithelium
Where can thyroglossal cysts be found?
Anywhere in midline, down to retrosternum
Where are the most common thyroglossal cysts?
Lingual Midline neck, C3 Substernal Lateral Strumal: heart Struma ovarii: thyroid in ovary: functional!
What is the most common cause of high PTH?
Parafollicular adenoma
What causes Parathyroid hyperplasia?
Low Ca
Renal disease is common
Leads to adenomas
What is the histology of a parathyroid adenoma?
Lacks normal fat
