thyroid neoplasia

Question 1

classic presentation of thyroid neoplasia

Answer 1

distinct, solitary nodule

thyroid nodules more likely to be benign than malignant

Question 2

radioactive uptake studies and thyroid cancer

Answer 2

incr. in graves or nodular goiter

decreased uptake in adenoma and carcinoma

Question 3

biopsy of thyroid method

Answer 3

fine needle aspiration

Question 4

follicular adenoma

Answer 4

benign prolif of follicles surrounded by fiborus capsule. usually non-functional but rarely can secrete hormone

Question 5

types of thyroid cancer

Answer 5

papillar, follicular, medullary, anaplastic

Question 6

papillary carcinoma: risk factors, and importance

Answer 6

most common type of thyroid carcinoma
exposure to ionizing radiation in childhood is a major risk factor.
also with RET and BRAF mutations.

Question 7

papillary carcionoma histo

Answer 7

orphan annie nuclei- white clearing, nuclear grooves. may see psammoma bodies (concentric layered calcifications)

Question 8

papillary carcinoma spread and progonsis

Answer 8

often spreads to the cervical lymph nodes

good prognosis even when it spreads

Question 9

follicular carcionoma

Answer 9

malignant prolif of follicles surrounded by fibrous capsule, but there is invasion through the capsule in carcinoma. Fine needle biopsy can’t distinguish btw follicular adenoma and follicular carcinoma.

Question 10

follicular carcinoma spread and prognosis

Answer 10

generally, metastasis occurs hematogenously
(usually carcinoma spreads locally, so this is an exception. others carcinomas that spread hematogneously: renal cell carcinoma, hepatocellular carcionoma, choriocarcinoma).

Question 11

medullary carcionma

Answer 11

malignant proliferation of parafollicular c cells. associated with high levels of cacitonin produced by tumor. may lead to hypocalcemia
some calcitonin may deposit within the tumor as local amyloidosis.

Question 12

medullary carcinoma histo

Answer 12

malignant cells in an amyloid stroma

Question 13

familial cases of medullary carcionma of the thyroid

Answer 13

MEN2A and MEN2B: neoplasia in multiple endocrine organs
often associated with mutations in the RET oncogene. if there is a RET mutation, you should remove the thyroid prophylactically

Question 14

anaplastic carcinoma

Answer 14

undifferentiated malignant tumor of the thyroid classically seen in the elderly
often invades local structures leading to dysphagia or resp. compromise
poor prognosis

Question 15

complications of thyroidectomy

Answer 15

hoarseness (recurrent laryngeal nerve damage), hypocalcemia (removal of parathyroids), and transection of the inferior thyroid artery