Tyroid Nodule Flashcards
4 types of malignant tyroid neoplasms
- Papillary (85%)
- multifocal, LN - Follicular/Hurthle (5%)
- vascular spread - Anaplastic ( undiff)
- medullary
- spread via blood
Two types of follicular/Hurthle cell carcinoma
- minimally invasive
2. Widely invasive
Anaplastic carcinoma
- older age group
- poor survival - rapidly growing
- 3 patterns
- spindle cells
- giant cell
- squamoid cells - necrosis or hemorrhage
Medullary carcinoma
- solid proliferation of cells with granular cytoplasm (parafollicular C Cells)
- Highly vascular stroma
- Hyalinized collagen and/or amyloid
- RET mut
What nerve runs behind the thyroid and into the trachea?
recurrent laryngeal
Metastatic cancers that like to spread to thyroid gland
- melanoma
- lung
- head and neck
- renal
- breast
- colon
If a patient has a TSH test, US and gets an FNA, and the results turn out to be indeterminant, what is the next step?
Consider nuclear imaging
Proto-oncogene
nl gene which codes for a protein that promotes nl cell division
Oncogene
Mutated gene which codes for a protein that causes unregulated cell division
(gas)
Tumor suppressor gene
Nl gene which codes for a protein that restrains cell division or that promotes cell differentiation, DNA repair or apoptosis
(P53, RB - brakes)
Tumors result from ____ activation or _______ loss
oncogene, TSG loss
Most common mutation in all thyroid cancers
BRAF - proto oncogene is point mutated
*BRAF alone cant cause anaplastic, need to take off the brakes too (p53)
Pax8-PPARy mut can cause which type of thyroid cancer?
follicular thyroic carcinoma
Some mutations that can cause papillar thyroid carcinoma
RET/PTC Trk Met Ras BRAF!!
