Thyroid Pathology

Question 1

Hashimoto thyroiditis: histological features (3)

Answer 1

lymphocytic inflammation, germinal centers, and Hurthle cell change

Question 2

dx: tender thyroid

Answer 2

subacute de Quervain thyroiditis

Question 3

subacute de Quervain thyroiditis: clinical presentation, histology

Answer 3

self-limited disease following a flu-like illness; very tender thyroid; granulomatous inflammation (neutrophils, giant cells)

Question 4

dx: hard (rock-like) thyroid

Answer 4

fibrous (Riedel) thyroiditis

Question 5

fibrous (Riedel) thyroiditis: clinical presentation

Answer 5

hard, fixed, painless thyroid

Question 6

dx: scalloped colloid on histology

Answer 6

Graves disease (hyperthyroidism)

Question 7

dx: thyroid cancer, BRAF mutations

Answer 7

papillary carcinoma

Question 8

dx: thyroid cancer, RET mutations

Answer 8

medullary carcinoma

Question 9

dx: thyroid cancer, “Orphan Annie” nuclei

Answer 9

papillary carcinoma

Question 10

papillary carcinoma of thyroid: unique features (4)

Answer 10

lymphatic invasion common, excellent prognosis, “Orphan Annie eyes” nuclei, BRAF mutations

Question 11

follicular carcinoma of thyroid: unique features (2)

Answer 11

invades thyroid capsule (unlike follicular adenoma), no cytologic features of malignancy

Question 12

ionizing radiation during childhood predisposes patients to what thyroid cancer?

Answer 12

papillary carcinoma

Question 13

what thyroid cancer arises from parafollicular “C cells?”

Answer 13

medullary carcinoma

Question 14

dx: thyroid cancer that stains positive for chromogranin

Answer 14

medullary carcinoma

Question 15

dx: nests of neuroendocrine cells in amyloid stroma

Answer 15

medullary carcinoma

Question 16

anaplastic carcinoma of thyroid: clinical presentation

Answer 16

older patients with hoarseness and neck pain