Thyroid Nodules Flashcards
malignant nodules
in men
ages 60
PE of thyroid nodule
character
solitary or multiple
lymphadenopathy
extrathyroid manifestations
fine needle aspiration
requires pathologist
90% sensitivity and specificity
for nodules >1cm or suspicious US**
benign on FNA
need follow up 6-12 months
malignant on FNA
surgery
check before surgery
that not MEN2A
VMAs and metanephrines - check if pheochromocytoma
RET positive
prophylactic thyroidectomy
orphan annie eyes
papillary carcinoma of thyroid
testing of thyroid
TSH/T4
ultrasound
FNA
not useful in follow up of medullary
thyroglobulin
radiation of neck
risk fx for papillary carcinoma of thyroid
thyroid nodule with nodes
papillary carcinoma
prognosis - depends on risk
high risk - >40, male, capsular invasion, distant mets, >4cm, poorly differentiated
hurthle cells
follicular carcinoma of thyroid
follicular carcinoma
evaluated based on genetics - to determine likelihood of malignancy
high calcitonin
with medullary carcinoma
-parafollicular C cells
75% sporadic
follow up - calcitonin (thyroglobulin no use)
