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Reproduction Flashcards > Thyroid Pathology > Flashcards

Thyroid Pathology Flashcards

1
Q
A

Chronic lymphocytic thyroiditis / Hashimoto’s thyroiditis

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2
Q
A

Chronic lymphocytic thyroiditis / Hashimoto’s thyroiditis, magnified

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3
Q

What cell type is the top arrow pointing to? What about the bottom arrow?

A

Follicular cells

C cells

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4
Q
A

Graves disease

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5
Q

What cell type is the arrow pointing to?

A

Oncocytic cell / Hurthle cell

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6
Q

What are characteristic features of oncocytic / Hurthle cells?

A
  • Eosinophilic / pink cytoplasm
  • Round nucleus
  • Prominent nucleolus
  • Seen in both benign and malignant lesions
  • Metaplastic follicular cell
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7
Q

What type of cell is the arrow pointing at?

A

Oncocytic cell

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8
Q

What are the arrows pointing to?

A

Oncocytic / Hurthle cell

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9
Q

What oncogene is commonly rearranged in endocrine tumors, specifically papillary thyroid carcinoma?

A

RET (rearranged during transfection)

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10
Q

What chromosome is Ret on? What does the gene do? How common is this chromosomal change?

A
  • chromosome 10 INVERSION (rearrangement)
  • tyrosine kinase domain gets overactivated
  • 60-80% of papillary thyroid carcinomas occurring after irradiation
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11
Q

Which is Graves? Which is Papillary carcinoma? How do you know?

A

Papillary carcinoma is the one on the left - can tell because nuclei are empty-looking, enlarged, and have creases.

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12
Q

Which is Graves? Which is papillary carcinoma?

A

Graves is on the right, papillary carcinoma is on the left. Similar architecture but the nuclear cytology is very different!

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13
Q

What is this? What are some important features?

A

Papillary carcinoma. Papillary cores, blood vessel, and empty-looking nuclei.

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14
Q

Arrow?

A

Nuclear inclusion (seen in papillary carcinoma)

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15
Q
A

Nuclear groove seen in papillary carcinoma

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16
Q

Is the diagnosis of papillary carcinoma based on architecture or based on nucleus?

A

Nucleus - the architecture can vary quite a lot. (Papillae, follicles, tall cell variant).

17
Q

Does follicular carcinoma metastasize by lymphatics or blood vessels? Where does it go?

A

Blood vessels - goes to distant organs like brain, lungs, or bone.

18
Q

What are the empty spaces in this image? What is the thing in the middle? What is this?

A

The empty spaces are blood vessels. This tumor is sitting in the blood vessel. It is a follicular carcinoma.

19
Q

How is a follicular carcinoma diagnosed? Contrast with papillary carcinoma?

A

Follicular carcinoma is diagnosed by invasion into the capsule and or the capsular vessels. Papillary carcinoma is diagnosed by nuclear features.

20
Q

Can papillary carcinoma present as multiple tumors in the thyroid? What about follicular carcinoma?

A

Papillary carcinoma presents as multiple tumors; follicular carcinoma presents as a single tumor.

21
Q

How does Ret involvement differ between papillary carcinoma (due to radiation) and medullary carcinoma (familial)?

A

For papillary carcinoma, we are thinking of Ret gene REARRANGEMENT.

For medullary carcinoma we are thinking of Ret gene MUTATION.

22
Q

Can you treat C cell tumors with radioactive iodine?

A

No - they don’t use it

23
Q

What stain is used to identify amyloid?

A

Congo red

24
Q

Three ways to diagnose medullary carcinoma?

A
  1. Stain for calcitonin, 2. Look at cytology, 3. Measure calcitonin (should be high)
25
Q

What is the most common thyroid carcinoma?

A. follicular carcinoma

B. papillary carcinoma

C. medullary carcinoma

D. anaplastic carcinoma

A

B, papillary carcinoma

26
Q

What is this a histological image of (ignore the arrow)?

A. Papillary Carcinoma

B. Follicular Carcinoma

C. Medullary Carcinoma

D. Anaplastic Carcinoma

E. Graves Disease

A

D. Anaplastic carcinoma

27
Q
A

Anaplastic carcinoma - note the necrotic areas

28
Q

Histologic features of anaplastic carcinoma?

A

Pleiomorphic tumor cells - can show spindle cells and multinucleated giant cells

29
Q

From what cell type are medullary carcinomas derived? How do they metastasize?

A

C cells. Via blood vessels and lymphatics.

30
Q

What thyroid carcinoma is this?

A

Medullary carcinoma

31
Q

This thyroid carcinoma is probably…

A

Medullary carcinoma

32
Q

This thyroid carcinoma is probably…

A

Medullary carcinoma

33
Q
A

Follicular carcinoma with invasion

34
Q
A

Papillary Carcinoma, Follicular Variant

35
Q

This is an example of:

A. Papillary Carcinoma, papillary variant

B. Follicular Carcinoma

C. Graves Disease

D. Papillary Carcinoma, follicular variant

A

D - you can tell because the nuclei are very characteristic, but the cells are not forming papillae (not sure I entirely see this).

36
Q
A

Papillary Carcinoma Tall Cell Variant

37
Q
A

Follicular Adenoma

Reproduction Flashcards (11 decks)

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