Thyroid nodules (E&M) Flashcards
Define thyroid nodules.
Abnormal growths within the thyroid glands - they are usually non-functioning
Which groups do thyroid nodules happen more commonly in? (2)
- F>M
- incidence increases with age
What are some benign causes of thyroid nodules? (4)
- multinodular goitre
- Hashimoto’s thyroiditis
- thyroid adenoma
- thyroid cyst
What are types of thyroid cysts (benign thyroid nodules)? (3)
- colloid - overgrowths of normal thyroid tissue (most common type of thyroid nodules)
- simple - growths that are filled with fluid/partly solid and partly filled - pose low risk for cancer = monitored/biopsies if >2cm
- haemorrhagic
What are some malignant causes of thyroid nodules? (3+3)
- thyroid carcinoma:
- papillary carcinoma
- follicular carcinoma
- medullary carcinoma
- anaplastic carcinoma
- lymphoma
What are the three types of thyroid carcinoma (malignant thyroid nodules)?
- papillary carcinoma - most common, 30-40y
- follicular carcinoma - second most common, 30-60y
- medullary carcinoma
Where can papillary carcinoma metastasise to?
Cervical lymph nodes
What can you use as a tumour marker for papillary carcinoma?
Thyroglobulin
What do you see on light microscopy in papillary carcinoma?
Orphan Annie eyes
What is the prognosis of papillary carcinoma like?
Very good
When is follicular carcinoma more common?
In areas of low iodine and in women (30-60y)
Where does follicular carcinoma metastasise to?
Lung and bones
What can you use as a tumour marker for follicular carcinoma?
Thyroglobulin
What is medullary carcinoma?
Cancer of parafollicular cells, secretes calcitonin
What hereditary condition is medullary carcinoma a part of?
MEN-2 (Multiple Endocrine Neoplasia Type 2):
- medullary carcinoma
- parathyroid hyperplasia
- phaeochromocytoma
What are the risk factors for thyroid cancer? (4)
- radiation
- family Hx
- rapid enlargement/compression
- lymphadenopathy
What are some different types of neck lumps? (7)
- reactive lymphadenopathy - tender LNs, Hx of local infection/viral illness
-
lymphoma - rubbery and painless lymphadenopathy, B symptoms (fever, WL, night sweats), splenomegaly
- thyroid lymphoma linked with Hashimoto’s thyroiditis
- thyroid swelling - hypo/hyper/euthyroid Sx, moves upwards on swallowing
- thyroglossal cyst - mass that develops from tissues that remains after formation of thyroid gland
- pharyngeal pouch - part of pharyngeal lining herniates through pharyngeal wall
- branchial cyst - embryonic remnant
- carotid aneurysm
What are the clinical features of lymphoma (thyroid nodules)? (3)
- rubbery and painless lymphadenopathy
- B symptoms - fever, WL, night sweats
- splenomegaly
What are the clinical features of thyroid swelling (thyroid nodules)? (2)
- hyper/hypo/euthyroid symptoms
- lump moves upwards on eating
What are the clinical features of a thyroglossal cyst (thyroid nodules)? (4)
- age <20y
- midline
- moves upwards on protrusion of tongue
- painful if infected
What are the clinical features of a pharyngeal pouch? (7)
- older men
- not seen usually but if large, then midline mass
- gurgles on palpation
- dysphagia
- regurgitation
- aspiration
- chronic cough
What are the clinical features of a branchial cyst (thyroid nodules)? (4)
- oval, mobile, cystic mass
- between SCM and pharynx
- presents in early adulthood
- contains cholesterol crystals
What are the clinical features of carotid aneurysm (thyroid nodules)? (3)
- pulsatile
- lateral neck mass
- does not move on swallowing
How do most thyroid nodules present?
Asymptomatic
