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)
anaplastic carcinoma
painful, rapidly enlarging mass
bad prognosis
diagnosed with FNA
surgery for
hot nodule
toxic nodular goiter
graves disease
MNG
NOT in thyroiditis
complications of thyroid surgery
recurrent and superior laryngea nerve
hypoparathyroidism
hypothyroidism
blood loss and infection rare
