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Endocrine > Thyroid Pathology > Flashcards

Thyroid Pathology Flashcards

1
Q

Lesion architecture/growth patterns of thyroid lesions

A

follicular, papillary, solid, trabecular w/ fibrosis, calcifications, or amyloid

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2
Q

T/F thyroid lesions with calcifications should be biopsied

A

T

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3
Q

Papillary formation

A

hyperplastic proliferation of follicular epithelium results in invagination of cells into lumen of follicle –> VEGF mediated central blood supply –> papillary formation

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4
Q

T/F multiple/solitary nodules are usually benign

A

multiple –> usually benign but can have neoplasm in background

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5
Q

2 main types of diffuse thyroid enlargements

A

hyper: diffuse toxic goiter (Graves)
hypo: chronic lymphocytic thyroiditis (Hashimoto’s)

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6
Q

Graves Disease: increase/decrease in colloid

A

decrease

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7
Q

Graves Disease: increase/decrease in vascularity

A

increase

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8
Q

Histological features of Graves

A

follicular hyperplasia, lymphocytic infiltration in stroma

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9
Q

T/F there is hyperplasia in hashimotos

A

F

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10
Q

Histologic features of hashimoto’s

A

infiltration of lymphocytes and plasma cells, follicular atrophy, oncocytic metaplasia

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11
Q

T/F atrophic colloid is functional

A

F

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12
Q

Hurthle cell

A

oncocytic –> metaplastic follicular cell

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13
Q

T/F lymphocytic metaplasia in hashimoto’s is limited to stroma

A

F –> throughout gland vs. only in stroma in Graves

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14
Q

At least ___% of US pop has thyroid nodules.

A

60%

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15
Q

C cells are located in the lateral/medial thyroid

A

lateral

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16
Q

Malignant tumor of c cells

A

medullary carcinoma

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17
Q

C cell hyperplasia is found in _____ syndrome

A

MEN 2

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18
Q

Gross pathology of non toxic goiter

A

firm, diffusely enlarged –> rough multinodular, calcification, fibrosis, cystic degeneration

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19
Q

T/F calcifications can be found in benign and malignant nodules

A

T

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20
Q

T/F non toxic nodular goiters are non-heterogeneous on histologic exam

A

T

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21
Q

Histologic features of non toxic nodular goiters

A

large and small follicles, columnar or cuboidal epithelium, follicular hyperplasia/papillary growth, fibrosis

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22
Q

fibrosis in non toxic nodular goiter

A

thyroid nodules outgrow blood supply –> degeneration of nodules –> fibrosis

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23
Q

Most common thyroid neoplasm

A

well-differentiated thyroid neoplasm –> same architecture (follicles and papillae) –> still produce Tg

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24
Q

Most common benign thyroid epithelial neoplasm

A

follicular adenoma –> white circumscribed capsule

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25
Q

Malignant tumors of thyroid are more common in M/F

A

F –> nodules in general more common in women

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26
Q

Most thyroid carcinomas are indolent/aggressive

A

indolent –> can treat with radioactive iodine b/c well differentiated still can absorb iodine and have functional receptors

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27
Q

Most well known etiological factor for thyroid carcinoma

A

irradiation especially in childhood (Chernobyl) leading to papillary carcinoma

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28
Q

Which gene rearrangements are common to irradiation of thyroid

A

Ret oncogene (in addition to RAS, BRAF, p53, APC)

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29
Q

Which carcinoma is the primary result of thyroid irradiation

A

Papillary carcinoma (well differentiated malignant neoplasm of thyroid)

30
Q

T/F thyroid carcinoma due to irradiation can result from mutations

A

F –> rearrangements

31
Q

RET

A

rearranged in endocrine tumors –> chimeric oncogene on chr10 –> overactivation of tk domain

32
Q

T/F RET/PTC is specific to papillary thyroid carcinoma

A

T

33
Q

Two main well differentiated follicular cell carcinomas

A

PTC, follicular carcinomas

34
Q

PTC is common to iodine sufficient/deficient regions

A

sufficient

35
Q

PTC are known as micro/macro carcinomas

A

micro

36
Q

T/F 30% of US pop has a microcarcinoma in thyroid

A

T

37
Q

Where does PTC metastasize to?

A

lymph nodes

38
Q

Dx of PTC

A

nuclear features NOT invasive growth

39
Q

Histologic features of PTC

A

nuclear inclusion/groove, elongated cells, clear nuclei

40
Q

Tall cells

A

tall cell variant of PTC has really tall cells

41
Q

Variants of PTC

A

papillary, follicular, tall cell

42
Q

10 year survival of PTC

A

90%

43
Q

Risk factors for PTC aggressive growth

A

male, older age, tall cell, distant mets

44
Q

Follicular carcinoma is common in iodine deficient/sufficient areas

A

deficient

45
Q

T/F follicular carcinoma shows up with older age

A

T

46
Q

T/F PTC can present at all ages

A

T

47
Q

T/F Follicular carcinoma are encapsulated

A

T –> like an adenoma except with invasion of tumor capsule and capsule vessels

48
Q

How does Follicular carcinoma metastasize

A

hematogenous spread

49
Q

Papillary or Follicular? most common thyroid cancer

A

papillary

50
Q

Papillary or Follicular? Dx based on nuclear morphology

A

papillary

51
Q

Papillary or Follicular? dx based on invasion

A

follicular

52
Q

Papillary or Follicular? mets via lymph

A

PTC

53
Q

Papillary or Follicular? mets via blood

A

follicular

54
Q

Papillary or Follicular? multiple tumors

A

PTC

55
Q

Papillary or Follicular? single tumor

A

follicular

56
Q

Papillary or Follicular? ras mutations

A

follicular

57
Q

Papillary or Follicular? ret mutations

A

PTC

58
Q

c cell derived carcinoma

A

medullary carcinoma

59
Q

Medullary carcinoma involves mutations of _____ oncogene

A

Ret

60
Q

Tumor nest

A

pathologic feature of medullary carcinoma with amyloid background

61
Q

Medullary carcinoma produces ____

A

calcitonin

62
Q

T/F can treat medullary carcinoma with radioactive iodine

A

F

63
Q

5 year prognosis of medullary carcinoma

A

50%

64
Q

Amyloid in thyroid indicates ____

A

medullary carcinoma –> byproduct of calcitonin production

65
Q

Medullary carcinoma metastasizes via

A

blood and lymph

66
Q

Dx medullary carcinoma

A

cytology or calcitonin stain or measure calcitonin levels

67
Q

Anaplastic carcinoma of thyroid

A

fatal, 5% of thyroid malignancies, pt’s over 60

68
Q

Most aggressive tumor of thyroid/body

A

anaplastic carcinoma

69
Q

T/F anaplastic carcinoma often preceded by hx of goiter

A

T –> multinodular more common

70
Q

Anaplastic carcinoma more common in M/F

A

F

71
Q

T/F Anaplastic carcinomas can be treated with radioactive iodine

A

F –> not well differentiated and does not produce Tg

72
Q

Histology of anaplastic carcinoma

A

Multinucleated giant cells, pleomorphic, spindle cells

Endocrine (26 decks)

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