2-6: 5/17: Thyroid Pathology Updated

Front 1

Thyroid epithelium is ______ and contains __________ inside it.

Back 1

cuboidal
contains colloid

Front 2

What is a thyroglossal cyst?

Epithelial cell type?

Back 2

Thyroid tissue that develops along path of migration from foramen cecum to position in neck

Ex: Lingual thyroid

Epithelium can be squamous OR respiratory epithelial (CILIATED PSEUDOCOLUMNAR)-lined cysts with severe chronic inflammation and often thyroid tissue in wall

Front 3

Gross features of a dyshormonogenetic goiter.

Back 3

Massive enalrgement of thyroid with MULTIPLE hyerplastic nodules

Front 4

Gross features of Hashimoto's Disease.

Back 4

Gland appears tan-white due to presence of lymphoid hyperplasia (may appear more white as disease progresses due to fibrosis)

(normal thyroid appearance is gray)

Front 5

Diagnose:
Extensive lymphocytic and plasmacytic infiltrates
Lymphoid follicles with germinal centers
Atrophic thyroid follicles lined with Hurthle cells

Back 5

Hashimoto's

Front 6

Describe histology of Hashimoto's Disease.

Back 6

Lymphoid infiltrates with germinal centers
Eosinophilic (Hurthle cell) change of follicular epithelium (lots of mitochondria, very eosinophilic)

Front 7

How would a trophoblastic tumor induce thyrotoxicosis?

Back 7

hCG can bind to TSH receptor

Front 8

Graves' Disease Triad

Back 8

Hyperthyroidism
Proptosis
Pretibial myxedema

Front 9

Gross features of Graves' Disease.

Back 9

Diffuse enlargement of thyroid

Front 10

Describe histology of Graves' Disease.

Back 10

Follicular cells are tall and crowded
Small paipllae may be present (but lack fibrovascular cores)
Pale colloid with SCALLOPED margins
T-cell predominant lymphoid infiltrate
Germinal Centers

Front 11

Riedel's Thyroiditis:
Simulates __________
Why?

Back 11

ANAPLASTIC carcinoma because of infiltrative growth pattern and fibrosis.

Front 12

Diagnose:
Enlargement of thyroid in absence of hyper- or hypo-thryoidism.

Back 12

Non-toxic nodular goiter

Front 13

Histologic features of non-toxic goiters.

Include FNA description.

Back 13

Large pools of colloid

Flat sheets of cells
Some macrophages if there is hemorrhage (they clear up the blood)

Front 14

Diagnose:
Benign encapsulated neoplasm with evidence of follicular cell differentiation

Back 14

Follicular adenoma

Front 15

Histologic features of follicular adenoma.

Back 15

Compression of surrounding thyroid
Fibrous (usually thin) capsule
Solitary nodule
Uniform follicular structure

Front 16

Histologic features of adenomatous nodules.

Back 16

No compression of adjacent thyroid
Irregular and incomplete encapsulation
Variable follicular structure
No compression of adjacent thryoid

Front 17

Hurthle Cells AKA

Back 17

ONCOCYTIC CELLS

Front 18

Papillary Thyroid Carcinoma:
Degree of differentiation
Histologic feature

Back 18

Follicular cell differentiation

Papillae and/or distinctive nuclear features

Psammoma bodies!

Front 19

This cell represents an area of calcfication surrounding necrotic tumor cells.

Back 19

Psammoma bodies

PAPILLARY CARCINOMA

(AKA sand-like bodies)

Front 20

This carcinoma exhibits clear nuclei with prominent grooves.

Back 20

Papillary carcinomas

Front 21

How does a papillary thyroid carcinoma appear in FNA?

Back 21

3-D structure, crowding of cells

May also see pseudoinclusions

Front 22

This thyroid carcinoma is spread via lymphatics.

Back 22

Papillary

Front 23

Diagnose:
Malignant epithelial tumor showing follicular cell differentiation and not belonging to any other distinctive types of thyroid malignancy

Back 23

Follicular carcinoma

Histo features small capsule
(may invade capsule, BV's)

Front 24

This carcinoma is associated with PAX8-PRARgamma rearrangements.

Back 24

Follicular carcinoma

Front 25

Gross features of follicular carcinoma.

Back 25

THICK capsule
(histo: small follicles)

Front 26

This thyroid carcinoma spreads via vasculature.

Back 26

Follicular carcinoma

Front 27

This thyroid carcinoma metastasizes to bone.

Back 27

Follicular carcinoma

Front 28

This thyroid carcinoma occupies an intermediate place (both morphologically and clinically) between the well -differentiated papillary and follicular carcinomas and undifferentiated carcinoma.

Back 28

POORLY differentiated carcinoma

Front 29

Histologic features of poorly differentiated carcinoma.

Back 29

Insular (islet-like) growth pattern
LOTS of mitoses
Necrosis

Front 30

This thyroid carcinoma lacks evidence of papillary or follicular differentiation. It is composed of sheets of undifferentiated cells with prominent mitoses.

Back 30

Undifferentiated carcinoma (lose epithelial carcinoma)