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15 Cards in this Set

  • Front
  • Back
thyroglossal duct cyst

GROSS: disappears w/ aspiration; fluid color not indicator of malignact potential.

HISTO: ciliated columnar epithelium, crystalline material, multinucleated giant cell.
simple colloid goiter
GROSS: enlarged w/ glistening/waxy surface

HISTO: huge colloid filled follicles.

CYTO: abundant colloid, scant uniform follicle cells.
adenomatous multinoduloar goiter

GROSS: multinodular (solid, cystic, hemorrhagic)

HISTO: pseudo papillations. no true capsule

CYTO: variable colloid, follicular cells numerous, honeycomb patterns. confused w/ follicular neoplasms.
graves dz
hyperthyroidism. dx via TFT and hx.

GROSS: red beefy

HISTO: hyperplasia of follicular cells, colloid thin, scalloping, pseudopolyps (polsters).

CYTO: fresh blood, thin colloid, lots of follicle cells, FLAME CELLS. pseudo-neoplastic: more follicle cells than colloid, nuclear overlap, anisonucleosis.
subacute thyroiditis
post viral (HLA B35)

-tender, nodularity may develop.

HISTO: giant cells, granulomas, fibrosis,

CYTO: scanty due to fibrosis, multinucleate giant cells, degenerating follicle cells, epithelioid histiocytes
hashimotos thyroiditis
-autoreactive CD4+ cells initiate process => CD8 cytotoxic death, cytokine mediated death, or antibody assisted death of thyrocytes.

GROSS: enlarged thyroid!!! fishy fleshy

HISTO: numerous lymphoid follicles w/ germinal centers, hurthle cells, overall loss of thyrocytes.

CYTO: small lymphos and scattered plasma cells.

increased incidence of malignant neoplasms
thyroid neoplastic conditions
-incr w/ age, women 4x more affected

-majority of solitary nodules are non neoplastic

-neoplastic nodules are mostly benign

-nodules in younger pts and males are more likely neoplastic

-radiation to head/neck => incr thyroid malignancy

-papillary more common in iodine rich and women.

-behavior of nodule based on histo and cyto.
papillary carcinoma
-RET protooncogene, prior ionizing radiation.

GROSS: solid or cystic, hemorrhagic, rarely a true capsule.

HISTO: true papillations w/ vascular core, PSAMMOBODIES, orphan annie eyes, nuclear irregularities.

CYTO: cellular smears w/ papillary clusters of cells.

MOLEC: RET or NTRK1, mutations in BRAF, RAS.
papillary variants
-follicular variants: same prog as papillary carcinoma but harder to dx.

-tall cell: 3x taller than wide, seen in hashimotos, very aggressive. lymphocytes.

columnar cell: secretory endometrium like cells, worse than papillary CA.

diffuse sclerosis: fibrosis, lymphocytic background, worse prognosis.
follicular adenoma
GROSS: solitary nodule, solid or cystic.

HISTO: complete encapsulation w/ thinner capsule than F-CA. microfollicles w/ scant thyroglobin

CYTO: cellular smear, equal sized clusters, cellular overlap, 3d groups, scanty colloid to no colloid.

MOLEC: TSH recep abnormalities, point mutation in RAS.
follicular carcinoma
GROSS: solitary nodule, thick capsule w/ necrosis, cystic change, or hemorrhage. Extension through capsule and adherence to nearby structures in neck.

HISTO: invasion through capsule or vessels otherwise identical to adenoma

CYTO: same as adenoma (cellular smear, microfollicular groups, scant collioid)

MOLEC: RAS mutation, PAX8-PPAR translocation.
hurthle cells
oncocytic cells, pink cytoplasm, round smooth nucleus, prominent nucleolus.
clear cell
clear or vacuolated cytoplasm, signet ring appearance
medullary carcinoma
-RET protoncogene

GROSS: spontaneous type = single lesion; MEN's syndrome = multiple lesions. Not encapsulated, rarely necrotic, cystic, or bloody. highest C-cell conc @ upper 2/3 lateral lobes.

HISTO: nests of plasmacytoid/spindle shaped cells, amyloid, granular cytoplasm, calcitonin positive, congo red positive.

CYTO: dispersed cell pattern, plasmacytoid or spindle cells, uniform hyperchromasia & stippled chromatin, multinucleated forms possible

MARKERS: serum calcitonin

MOLEC: RET oncogene germ line mutation => constitutive activation of receptor. Seen in 95% of familial types
anaplastic carcinoma (giant cell)
-worse prognosis of all!!!

GROSS: fleshy tumor, hemorrhagic and necrotic.

HISTO: Spindle and bizarre cells, numerous mitoses, multinucleated cell forms, necrosis

CYTO: bizarre multinucleate and/or spindle cells. numerous mitoses, hyperchromatic, macronucleoli, necrotic cell fragments

MOLEC: mutated p53.