Thyroid and Ovarian Flashcards
Develops in the first trimester as an
outgrowth of cells from the pharynx
Thyroid gland
Remnants of thyroid tissue can persist into
childhood or adulthood along this pathway
leading to _____.
thyroglossal cysts or nodules
Normal adult thyroid gland: two lobes
joined in the midline by an
isthmus
Normal location of thyroid gland
anterior and slightly
caudad to the cartilages of the larynx
divide the thyroid gland into
pseudolobules
fibrous septa
Overalla enlargement of the thyroid gland is called
goiter
Roles of ultrasound in thyroid imaging
Detect and characterize nodules and
determine which lesions require biopsy
Guide in fine needle aspiration biopsy of
thyroid nodules that are difficult to palpate
Preferred frequency for linear array transducers in thyroid imaging
High; 10MHz or higher
Frequency for patients with thick neck or extensive goiter
7-10MHz
If there are several masses or nodules found in thyroid ultrasound, this usually
indicates the presence of
If there is only one mass, it may be
enlargement of thyroid gland (goiter)
cancerous and needs further evaluation
Shows image of the blood circulation in the gland
Color Doppler flow studies
Examination used biopsy to help the physician guide the needle to the mass that needs to be evaluated.
Also useful to direct removal of fluid from acyst (aspiration)
Ultrasaound
Echogenecity of nodules likely to be maignant
hypoechoic
Areas of cystic change within the nodule should be identified because this indicates a lesion that is likely
malignant or benign?
benign
areas of calcification within the nodule
should also be assessed. Fine punctate areas of
calcification often appear sonographically as high
amplitude echoes without acoustic shadowing. These are typical for ____ (malignant or benign) calcifications related to _____.
malignant
Psammoma bodies
Echogenecity of benign lesions (thyroid)
In general, benign lesions are isoechoic or
echogenic compared to normal background
echogenicity of the thyroid.
These nodules often have
a thin, well-defined hypoechoic halo on the
periphery of the lesion. There frequently are cystic
areas within these nodules.
Hyperplastic and adenomatous nodules
Appearance of benign lesions (thyroid) in color doppler
avascular debris within
the nodules that have undergone hemorrhagic
degeneration. A fluid level may be noted in
nodules that have acute internal hemorrhage.
Although calcification is relatively
uncommon with benign nodules, it is
frequently curvilinear and peripheral. This is
often referred to as _____
eggshell calcification
Not infrequently, multiple adenomas or
hyperplastic nodules result in diffuse
enlargement of the gland with multi-focal
disease known as
multinodular goiter
True cystic lesions of the thyroid are most
often colloid cysts. They are predominantly
anechoic but may have the presence of tiny
high amplitude echoes casting reverberation
artifacts known as _____ that are highly characteristic.
comet-tails
Benign inflammatory condition: diffusely enlarged gland demonstrating
hypoechoic areas with a very disorganized
and heterogeneous pattern
Chronic: color Doppler may
demonstrate prominent vascularity within infected
areas
Hashimoto’s Thyroiditis
The most common thyroid malignancy.
Papillary carcinoma
characteristically a sequela of long-standing Hashimoto’s Thyroiditis with lymphocytic infiltration of the gland.
lymphoma
Normal size of arahtroidgland in ultrasound
Pathologic size, appearance
<4mm
> 5mm, hypoechoic and
elongated mass between the posterior
longus colli muscle and anterior thyroid lobe
increased
PTH secretion is the result of a parathyroid
tumor, usually a single adenoma.
primary hyperparathyroidism
induced
by alterations renal function that cause a
hyperplasia of all parathyroid glands.
secondary hyperparathyroidism
hallmark of secondary hyperparathyroidism
or renal osteodystrophy. Appear as poorly
marginated broad bands of increased
radiopacity.
Commonly described in the
spine and appear as rugger-jersey
appearance.
osteosclerosis
In a normal 28-day cycle, a single dominant
follicle enlarges between day ___ and day ___.
The mean diameter increases during this
time from 1.0 cm to 2.0 cm.
day 9 and day 14
When the mean follicular diameter reaches
approximately 2 cm, ovulation is expected
within the next ___ hours.
24
IT develops from a follicle or a
corpus luteum by spontaneous rupture of blood
vessels into the cystic cavity.
hemorrhagic cyst
cysts that may develop in conditions associated with increased levels of human chorionic gonadotropin (hCG), such as hydatidiform mole, choriocarcinoma, maternal-fetal Rh incompatibility (erythroblastosis fetalis), multiple pregnancies, and diabetes.
Theca lutein cyst
dysfunctional hormonal cycles lead to chronic
anovulation beginning at menarche.
PCOS
Clinical manifestations may include hirsutism,
obesity, infertility and oligomenorrhea.
PCOS
in some patients with chronic
anovulation, the typical morphology is present:
large ovaries (>23 cc) and multiple (>10) small
follicles distributed in the periphery of each ovary
(cysts ranging up to 6 or 7 mm in diameter) giving
the so called ______
“string of pearls” appearance
infrequent complication in
patients receiving drug therapy for infertility.
OHSS - Ovarian Hyperstimulation Syndrome
commny used drugs in ohss
clomiphene citrate (Clomid) or human menopausal gonadotropins (hMGs)
