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Endo > Thyroid Pathology > Flashcards

Thyroid Pathology Flashcards

1
Q
A

Hashimoto Thyroiditis

Lymphoid tissue with Germinal Centers

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2
Q
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Hurthle Cell

Hashimoto Thyroiditis

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3
Q
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Subacute thyroiditis (deQuervain)

Supprurative (neutrophils)

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4
Q
A

Subacute Thyroiditis (de Quervain)

Granulomatous (giant cells)

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5
Q
A

Fibrous (Riedel) Thyroiditis

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6
Q
A

Graves’ Disease

Irregular follicles

Scallopped colloid

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7
Q

Histology of Goiter

A

Follicles lined by croweded columnar cells

Variably sized follicles

Abundant colloid

Initial stages result in symmetrical, diffuse enlargement

Recurrent episodes lead to a multinodular gland

With time develop degenerative changes (cysts, fibrosis, calcification, hemorrhage)

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8
Q
A

Thyroid Nodular Hyperplasia

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9
Q
A

Nodular Hyperplasia

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10
Q

Solitary palpable thyroid nodules

A

4x more common in women

Majority are non-neoplastic (focal hyperplasia, simple cysts) or benign (adenomas)

Carcinoma is relatively uncommon

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11
Q

What is used to test indeterminant or uncertain nodules?

A
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12
Q

Characteristics of Follicular Adenoma

A

Solitary

Completely surrounded by fibrous capsule

No capsular invasion or vascular invasion

Different growth pattern from adjacent normal gland

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13
Q
A

Follicular Adenoma

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14
Q
A

Follicular Adenoma - Variable appearances

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15
Q

Thyroid Carcinoma

A

Uncommon

Mortality is low

More common in women

All ages

Risk factor = exposure to ionizing radiation

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16
Q

Types of Thyroid Cancer

A

Papillary (85-95%)

Follicular

Medullary

Anaplastic

Lymphomas

Sarcomas

17
Q

Mutation in Follicular thyroid cancer

A

RAS oncogene

t(2;3)

PAX8-PPARgamma1 fusion gene

18
Q

Mutation in Papillary thyroid cancer

A

BRAF oncogene - inv(10)

RAS - t(10;17)

ret/PTC fusion gene

19
Q

Medullary Thyroid Cancer Mutation

A

RET (germ-line)

20
Q

Anaplastic Thyroid Cancer mutation

A

P53 tumor suppressor

21
Q

Most common form of thyroid cancer

Younger age group (20s-40s)

Metastasize by lymphatics

Cervical nodes involved in up to 50%

Excellent prognosis (>95% 20 year survival)

Adverse prognostic factors include: age >40, tumor >5cm, extrathyroidal extension adn osseous metastasis

A

Papillary thryoid Cancer

22
Q
A

Papillary Carcinoma

Gross

23
Q
A

Papillary Carcinoma Diagnosis

Papillary architectures

Chewing gum colloid

Multinucleated giant cells

24
Q
A

Papillary Carcinoma

Nuclear Features

25
Q

Second most common thyroid cancer

Presents older age (40s-50s)

Slowly spreading painless nodule

Vascular spread to bones, lungs, liver etc

Prognosis depends on stage at presentation

A

Follicular Thyroid Carcinoma

26
Q

Criteria for diagnosis of Follicular Carcinoma

A

No cytological features of malignancy

Most tumors well-differentiated

Capsular invasion

Vascular invasion

Minimally invasive carcinomas are difficult to distinguish from follicular adenomas and extensive sampling of the capsule is required

27
Q
A

Follicular Carcinoma

Capsular invasion

28
Q
A

Follicular Carcinoma

Vascular invasion

29
Q

Neuroendocrine tumors derived from the parafollicular (C-cells) of the thyroid

Secrete calcitonin

80% sporadic

20% within families as part of MEN-2 Syndrome

Incidence in 40s and 50s (except with MEN-2 in childhood)

40-60% survival at 10 years

A

Medullary Carcinoma

30
Q
A

Medullary Carcinoma

Nests of neuroendocrine cells

31
Q
A

Medullary carcinoma

Amyloid stroma

32
Q
A

Medullary Carcinoma

Calcitonin stain

33
Q

Undifferentiated tumors of follicular epithelium

Mean age is 65 years

May have history of long-standing goiter, differentiated thyroid carcinoma or concurrent papillary carcinoma

Extrathyroidal spread at presentation –> hoarseness and neck pain

Mean survival is 6 months

A

Anaplastic carcinoma

34
Q
A

Anaplastic carcinoma

Spindle cell type

35
Q
A

Anaplastic carcinoma

Epitheliod type

Endo (11 decks)

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