Thyroid nodule Flashcards
1
Q
typical nodule/CA sx
A
- incidental of physical
- pt finds it
- pt has nech SX
- Fam Hx of thyroid CA
- Hx of irradiation
2
Q
DDx for thyroid mass
A
solitary - cyst - thryoid adenoma - CA multiple - multinodular goiter
3
Q
2 investigations of thyroid mass
A
- TSH
2. US
4
Q
rule for biopsies
A
any solid nodule over 1cm needs to be biopsied unless hot
5
Q
when is biopsy not necc (3)
A
1.
6
Q
3 steps to assessment of nodule
A
- assess CA risk
- fam Hx, radition, large and growing rpidly - check TSH
- if normal go to step 3
- if supressed, do scan (if hot treat, if cold do step 3) - ultrasound and FNA biopsy
7
Q
2 imaging and indications
A
- US - best for viewing
2. radioisotope - only if TSH low
8
Q
what is HOT nodule
A
- overproducing
- looks black
- TSH low so rest of gland looks white
- ZERO CA risk
9
Q
what is cold nodule
A
- won’t take up radioscan
- TSH usually normal
- 5-15% chance of malig. in cold
10
Q
see flowchart on evaluation
A
you;ll like it, it’s pretty
11
Q
3 roles of pathologist
A
- decide the nodules that need surgery (FNA)
- determine biological nature of the nodule
- provide prognosticators
12
Q
what it “thyroid nodule”
A
descriptive terminaology, not a pathobiological entitiy
13
Q
2 common non-neoplastic possibilities
A
- MNG
2. hashimotos
14
Q
2 common neoplasitic possibilities
A
malignant - papillary thyroif carcinoma
benign - follicular adenoma
15
Q
2 diagnositc features of thyroid carcinoma
A
- nuclear features of PTC
2. invasive growth - CANNOT be assessed on FNA samples
