thyroid cancers Flashcards
what is the iodine uptake pattern in
graves
hashimoto
nodular goiter
adenoma
possible cancer?
graves - diffuse high uptake
hashimotos - diffuse low uptake
nodular goitre - multiple areas of high uptake
adenoma - single hot nodule
possible cancer - single cold nodule
what is the pathophysiology associated with follicular adenoma ?
benign proliferation of follicles
normal follicular tissue seen on biopsy
what is the spread associated with follicular adenoma ?
spreads hematogenously
what is the most common thyroid cancer ?
papillary carcinoma
what are the risk factors associated with papillary carcinoma ?
prior radiation exposure
childhood chest radiation for mediastinal malignancy
acne
survivors of atomic bombings
what type of spread is associated with papillary carcinoma ?
lymphatic
what are the histological findings associated with papillary carcinoma ?
on biopsy - branching papilla with fibrovascular cores ( looks like villi)
psammoma bodies
orphan Annie nuclei
what is the difference between follicular adenoma and follicular carcinoma ?
adenoma is non invasive of the fibrous capsule
what is the origin of medullary carcinoma ?
cancer of the parafollicular cells ( C cells)
and hence secrete calcitonin
what are the histological findings associated with medullary carcinoma ?
on biopsy there are amyloid deposits
demonstrates apple-green biferenginces with congo red stain
which of the MEN are associated with medullary carcinoma ?
MEN 2A and 2B
what is the cause of MEN neoplasia ?
associated with RET oncogene
what are the features of anaplastic carcinoma ?
happens in the elderly
highly metastatic
grows into the surrounding structures
what thyroid disease is commonly confused with anaplastic thyroid carcinoma ?
reidels thyroiditis
what are the histological features of anaplastic thyroid carcinoma ?
undifferentiated cells
no papilla - mafeesh ay 7aga
what are the features of the amyloid deposits found in medullary carcinoma ?
beta pleated
what is the mechanism of action of calcitonin ?
inhibition of osteoclast activity
whenever medullar carcinoma is mentioned and an associated gene is asked for ?
RET gene mutation
what gene mutation is associated with anaplastic carcinoma ?
TP53
what gene mutation is associated with follicular adenoma ?
RAS mutation
PAx8-PPAR gamma
