Thyroid Neoplasia and Diseases of Parathyroid Flashcards
Solitary thyroid nodules are more likely to be neoplastic than multiple nodules are
truth
What age, sex, health history, is associated with increased thyroid malignancy risk?
younger pts, males, history of radiation in the head/neck.
What characteristics of radionucleotide imaging predispose to a neoplasm
“cold” nodules 10% malignancy
“hot” nodules almost always benign
Who do you call if you do a fine needle aspiration and the result is a follicular lesion?
Surgeon. It could be a follicular adenoma (benign) or a follicular carcinoma (malignant), but you can’t tell the difference between the two so you’ve got to remove it either way. KNOW
Who do you call if it comes back a papillary lesion?
surgeon…papillary lesions in the thyroid are always malignant
What are the three types of benign thyroid nodules
colloid nodules (80% of the time)
cysts
follicular adenoma
What are the different types of malignant thyroid nodules?
Papillary carcinoma- most common malignant Follicular carcinoma medullary carcinoma anaplastic carcinoma rare malignancy
How do you tell the difference between a follicular adenoma and carcinoma
Follicular carcinoma will feature capsular and/or vascular invasion
Thyroid carcinomas account for about what percentage of human malignancies?
about 1%
Thyroid carcinomas in autopsy specimens
about 10%
Medullary and anaplastic tumors commonly arise at what age range?
After 40 years
Papillary and follicular carcinomas frequently arise at what age range?
Before 40 years
What is a psammoma body?
associated with papillary carcinoma, papillary calcium in thyroid tends to produce these calcified structures
Seen in many different neoplasms but mainly associated with papillary cancers (remember that papillary carcinomas can arise in organs besides the thyroid)
Carcinomas demonstrate vascular invasion
Adenomas do not
Medullary carcinoma is by definition what?
Tumor of the parafollicular C cells which produce calcitonin…get too much calcitonin release so pts present with hypocalcemia
What percentage of medullary carcinomas are sporadic?
80%
Of the non-sporadic medullary carcinoma, what are some major mutations?
MEN-IIA, MEN-IIB, non-MEN
Major clinical finding in medullary carcinoma?
hypocalcemia,,,,severe (may kill them)
Amyloid deposits associated with…
medullary carcinoma
Anaplastic carcinoma
RARE but TERRIBLE, invade locally and metastasize widely, usually affect older folks (mean age = 65)
- most pts have a history of some sort of thyroid disease
Lymphoma in the thyroid is almost always from what cell lineage?
B cell
What is the only known risk factor for thyroid lymphoma?
Hashimoto’s Thyroiditis
How many parathyroid glands are there?
4
What do they develop from?
third and fourth brachial pouches
Parathyroid adenoma
most are benign.
- Inc in PTH and hypercalcemia
- Most are asymptomatic
- Moans, bones, stones
Parathyroid hyperplasia
absolute increase in the mass of the parenchymal cells of the parathyroid gland. All or most of the glands are enlarged as opposed to one solitary gland in adenoma.
