Thyroid FNA Part 1

Question 1

Bi-lobed endocrine gland
Located in the anterior neck between the C5 and T1 vertebrae
Connected by an Isthmus
Wraps around the cricoid cartilage

Answer 1

Thyroid Gland

Question 2

Two paired arteries provide the blood supply for the thyroid, what are they?

Answer 2

Superior and the inferior thyroid arteries

Question 3

Thyrotropin-Releasing Hormone binds to receptors on endocrine cells w/in Anterior pituitary => stimulating endocrine cells to => synthesize & secrete —– ?

Answer 3

Thyroid-stimulating hormone (TSH)

Question 4

There is a Thyroid —– loop that occurs in Thyroid

Answer 4

Feedback loop

Question 5

TRH then enters bridge b/w hypothalamus & anterior pituitary gland —
What is the name of this bridge which is also known as a capillary bed?

Answer 5

Hypophyseal portal system

Question 6

2 types of hormones secreted by Thyroid?

Answer 6

T3 & T4

Question 7

Differentiate b/w the 2 types of Thyroid hormones

Answer 7

T3 is scarcer but 4x more potent than T4 which is more prevalent

Question 8

Why are the hormones referred to as T3 & T4?

Answer 8

T3: Triiodothyronine; contains 3 iodides
T4: Thyroxine; contains 4 iodide molecules

Question 9

Although both T3 & T4 winds up in systemic circulation, which gets converted to which?

Answer 9

T4 gets converted into T3

Question 10

TH targets the —- which causes —–
resulting in plasma glucose level increasing

Answer 10

Liver, Glycogenolysis,

Question 11

Thyroid is organized into pools of hormones and stabilizing proteins stored outside the cell as —–

Answer 11

Colloid

Question 12

Colloid is bound in a spherical fashion by —-?

Answer 12

follicular cells

Question 13

—– is the functional unit of the thyroid

Answer 13

Thyroid Follicle

Question 14

Follicular cell function- produce store and release thyroid hormones upon stimulation by pituitary-derived —- ?

Answer 14

TSH

Question 15

——- present in the thyroid which acts as substrate for synthesis of Thyroxine (T3) and triiodothyronine (T4)

Answer 15

Thyroglobulin- base glycoprotein

Question 16

Divided into lobules of 20-40 round to oval follicles, each 50-500 microns, with a single layer of —— to low —— ?

Answer 16

cuboidal, columnar epithelium

Question 17

Stroma contains —— , formerly called parafollicular cells (actually are intrafollicular), derived from —–

Answer 17

C cells, neural crest

Question 18

Which cells produces Calcitonin?

Answer 18

C cells

Question 19

Parathyroid —— calcium in blood while Calcitonin —— the calcium in blood

Answer 19

increases, decreases

Question 20

—- are present behind the thyroid &
produce parathyroid hormone; done by the —–

Answer 20

Parathyroid glands, chief cells

Question 21

Composed of chief cells (hormone secreting) and granular mitochondria rich oxyphilic cells

Answer 21

Parathyroid Glands

Question 22

Colloid follicle is lined by what type of epithelium?

Answer 22

non-stratified, cuboidal epithelium

Question 23

Increased iodine uptake produces —— ?

Answer 23

“Hot” nodules: darker in color

Question 24

Decreased iodine uptake produces —– ?

Answer 24

“Cold” Nodules: Lighter in color

Question 25

Hormone producing Flat to cuboidal to columnar in shape Honeycomb sheets Cell borders are not prominent Active follicular cells have more cytoplasm Nuclei do not crowd or overlap each other Very small, around the cell of RBC

Answer 25

Follicular Cells

Question 26

Round to oval nuclei Appr. The size of a lymphocyte Smooth membranes Granular chromatin Hyperchromatic Small nucleoli may be present

Answer 26

Benign Follicular Cells

Question 27

Large Granular eosinophilic cytoplasm Hyperchromatic nuclei Small nucleoli Polygonal

Answer 27

Hurtle Cells

Question 28

These cells were first described/named when found in which animal?

Answer 28

A dog

Question 29

Non-functional oncocytic cells Follicular cells which become packed with mitochondria Thyroglobulin (+)

Answer 29

Hurtle Cells

Question 30

Abundant granular cytoplasm Purple on (MGG) blue to orange on (Pap) Nuclei are often eccentrically located Enlarged nuclei Binucleation common Fine to coarse Chromatin

Answer 30

Hurtle Cells

Question 31

---- cells have HUGE nucleoli at times, coarse chromatin

Answer 31

Hurtle Cells

Question 32

Contains pools of thyroid hormones Pink to Gray on Pap Watery substance Blue to violet on Diff-Quik

Answer 32

Colloid

Question 33

Orange core & blue outer edges on Paps

Answer 33

Colloid

Question 34

What is the follow-up for Thyroid?

Answer 34

6 mos

Question 35

Adequacy for Thyroid

Answer 35

6 groups of well visualized follicular cells w/ 10 cells per group

Question 36

---- denotes ANY enlargement of Thyroid glands

Answer 36

Goiter

Question 37

What is the most commonly encountered Thyroid entity

Answer 37

Goiter

Question 38

Super cellular Small round dark cells that are columnar-cuboidal Macrofollicular fashion

Answer 38

Adenomatous Goiter (Nodular)

Question 39

Abundant thick watery colloid in the absence of follicular cells can be deemed a benign ---- ?

Answer 39

colloid goiter

Question 40

Subacute Thyroiditis also known as ---- or ----- ?

Answer 40

DeQuervain’s Thyroiditis or Granulomatous Thyroiditis

Question 41

Cytology: - Follicular cells, epitheloid histocytes and multinucleated giant cells (Langhans type) Lymphocytes, plasma cells ,eosinophils

Answer 41

Thyroiditis

Question 42

Another name for CHR Thyroiditis is ----?

Answer 42

Lymphocytic/Hashimoto's Thyroiditis

Question 43

What cells should you see in Hashimoto's Thyroiditis?

Answer 43

Hurtle cells (oncocytes) + Lyc

Question 44

Graves Disease is termed as ----- ?

Answer 44

Hyperthyroidism

Question 45

Consists of goiter, tremor, flushed skin, exophthalmos (eyeball protrusion)

Answer 45

Hyperthyroidism

Question 46

Cytology: -Tall columnar follicular cells -Paucicellular -Increased cytoplasm -Colloid within the vacuoles of follicular cells with bright red staining called “flame cells”

Answer 46

Hyperthyroidism

Question 47

Cause of hyperparathyroidism Hypercalcemia, loss of phosphate Possible renal failure May occur in patients with MEN Typically small

Answer 47

Parathyroid Adenoma

Question 48

Absence of colloid Composed mainly of chief cells with clear cytoplasm Similar appearance to thyroid (diagnostic problem) Honeycomb pattern No single morphologic criteria can separate PTA from MNG

Answer 48

Parathyroid Adenoma

Question 49

Why can a parathyroid Adenoma cause kidney failure?

Answer 49

It causes hypercalcemia which causes too much Ca2+ in blood - can cause kidney to fail