Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endocrinology > Thyroid Path > Flashcards

Thyroid Path Flashcards

1
Q

Describe an oncocytic cell: histological appearance and function

A

Metaplastic follicular cell with pink cytoplasm (lots of mitochondria) , round nucleus, round nucleolus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the appearance and function of C-cells

A

C-cells produce calcitonin

Located at lateral aspect of thyroid; rarely seen in regular histology until hyperplastic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Factors in histology: enlargement

A

Diffuse vs. nodular process– is nodule solitary or dominant? capsulated? Smooth or irregular borders?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Factors in histology: lesion architecture

A

Describes cell growth pattern:

Follicles, papillae, solid, trabecular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Other features of lesion that are important in thyroid lesion

A

fibrosis, calcification, amyloid (medullary carcinoma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe factors in tumor cell cytology

A

Cell size
Cytoplasm: indistinct or oncocytic
Nuclear morphology: shape and presence of folds/grooves or inclusions
Nucleoli: prominent; placement in nucleus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which types of enlargement are more likely to be malignant? Benign?

A

Nodular:
solitary=malignant
multiple=benign
diffuse: benign due to Graves or Hashimoto’s; can rarely be tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the gross pathology of Grave’s disease (4)

A

Symmetric and diffuse enlargement of thyroid gland
Red/brown cut surface
Decreased colloid
Increased vascularity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the histology of Grave’s disease (2)

A 
Papillary hyperplasia (increased follicles and irregular stroma)
Lymphocytic infiltration in stroma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe the gross pathology of Hashimoto’s thyroiditis: (2)

A

diffusely enlarged gland

Lobulated cut surface (white)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe the histological appearance of Hashimoto’s thyroiditis (3)

A

Follicular atrophy
Lymphocytic infiltration throughout gland
Oncocytic metaplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Prevalence of thyroid nodules

A

4-7% of US population

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the types of non-toxic nodular goiter? (4)

A

Endemic goiter (iodine deficiency)
Sporadic goiter
Chemically induced goiter
Dyshormonogenetic goiter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Gross pathology of non-toxic nodular goiter (big list)

A 
Heterogenous: Firm, diffusely enlarged
Cut surface is shiny and amber---increased colloid accumulation
Asymmetric enlargement
Multinodular
Hemorrhage
Calcification 
Fibrosis
Cystic degeneration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe the histological appearance of non-toxic nodular goiter

A

Variable sized follicles with columnar epithelium that can be tall or flattened
Papillary hyperplasia
Fibrosis (follicles outgrow blood supply)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe the gross appearance of a follicular adenoma (3)

A

Solitary

Well circumscribed/encapsulated

17
Q

Histological appearance of follicular adenoma (3)

A

Encapsulated nodule
Follicular, solid, trabecular growth pattern
No invasion

18
Q

What is the epidemiology of malignant epithelial tumors of thyroid?

A

Uncommon– 1-2% of all cancers

More common in females

19
Q

How do most thyroid tumors behave?

A

indolent

20
Q

What is pathogenesis of follicular cell

A

irradiation during childhood– causes papillary carcinoma due to ret oncogene rearrangements

21
Q

What are mutations of thyroid neoplasms? (5)

A 
Ret/PTC rearrangement
RAS
BRAF
p53
Adenomatous polyposis coli gene (APC)
22
Q

Describe RET/PTC rearrangement.

In which thyroid malignancy is this seen?

A

Inversion on chromosome 10 leads to over activation of tyrosine kinase of Ret

Seen in 60-80% of papillary thyroid carcinomas, especially due to irradiation

23
Q

What is cell of origin in epithelial neoplasms? What do they produce?

What are the two epithelial neoplasms?

A

Follicular cells, which produce thyroglobulin

Neoplasms are follicular cell carcinoma and papillary thyroid carcinoma

24
Q

Describe the epidemiology of papillary thyroid carcinoma

A

Most common type of thyroid cancer: 80% of thyroid cancers in non-endemic goiter regions

More common in women

25
Q

What are the pathological features for diagnosis in papillary thyroid carcinoma?
Nucleus

A

Nuclear features: elongation, chromatin clearing, membrane thickening, grooves and inclusions

26
Q

What are the growth patterns of papillary thyroid carcinomas?

A 
Papillary formations (core with stuff around)
Follicular variant-- colloid
Tall cells
27
Q

What is gross pathology of papillary thyroid carcinoma?

A

Cystic with mound of tumor cells

28
Q

Describe the clinical behavior of papillary thyroid carcinoma?

A

Aggressive– older age, male, large size, tall cell variant, distant metastases

29
Q

Describe the epidemiology of follicular carcinoma

A

5% of all thyroid carcinomas in US
Incidence increase with age
Common in iodide deficient regions

30
Q

Describe important features of follicular carcinoma (3)

A

Encapsulated tumor that invades
Hematogenous spread to brain, lungs and bone
Prognosis is dependent upon extent of invasion

31
Q

Describe the histological pathology of follicular carcinoma

A

Capsular but with vascular invasion. All about vascular invasion

32
Q

Name differences between papillary carcinoma and follicular carcinoma (3)

A
  1. Diagnosis based on nuclear morphology vs. vascular invasion
  2. Spread via lymphatics vs. blood vessels
  3. Presentation as multiple tumors vs. single tumor nodule
33
Q

From which cell type does medullary carcinoma originate?

What are causes? (2)

A

Originates from C-cells so produces calcitonin

It can arise from MEN2 disorders or be sporadic

34
Q

What is the pathogenesis of medullary carcinoma (what mutation is involved?)

What is prognosis?

A

Germ line mutation of ret-oncogene
Secretes calcitonin, other hormones

Prognosis is 50% at 5 years

35
Q

Describe the histological appearance of medullary carcinoma? (2)

A

Nest-like pattern (since its neuroendocrine–think theochromyocytomas!)
Stains for amyloid and calcitonin

36
Q

What is the prognosis for anaplastic carcinoma? Which patients are more likely to get this?

A

Prognosis: fatal– invade into surrounding neck structures

Constitutes 5% all thyroid malignancies

37
Q

What is epidemiology of anaplastic carcinoma? What is anapestic carcinoma usually preceded by?

A

Women>60 years of age
Preceded by a history of goiter
Can also result from de-differentiation of other thyroid malignancy

38
Q

Describe the histological appearance of anaplastic carcinoma .

What does it stain for?

A

Pleomorphic tumor cells– spindle cells and multinucleated giant cells

Does not stain for thyroglobulin, calcitonin

Endocrinology (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions