Pathology: Thyroid and Parathyroid Neoplasms Flashcards

1
Q

What do hot nodules indicate?

A

Growth is functional and almost certainly BENIGN

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2
Q

What do cold nodules indicate?

A

Growth is not functional and likely MALIGNANT

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3
Q

What do you do after a cold nodule shows up?

A

Call the surgeon, FNA possible too.

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4
Q

What is more likely in a single thyroid nodule?

A

Malignancy

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5
Q

What is more likely in multiple thyroid nodules?

A

Benign Goiter: rule out graves, hashimotos, etc…

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6
Q

How do you tell the difference between follicular adenoma and follicular carcinoma?

A

Invasion past capsule: impossible with FAN

TAKE IT OUT if it is an follicular lesion

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7
Q

What is the histology of a follicular lesion?

A

Uniform follicles producing colloid

Usually well capsulated, unless carcinoma

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8
Q

What are the general thyroid cancers of people under 40?

A

Papillary #1 (Psammoma bodies, lymphatic spread, previous ionizing radiation)
Follicular #2 (capsular invasion with follicles)

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9
Q

What are the general thyroid cancers of people over 40?

A

Medullary #1 (calcitonin, amyloid, hypocalcemia)

Anaplastic #2 (undifferentiated spindles, older patients)

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10
Q

Papillary carcinoma buzzwords?

A
MC thyroid cancer
Previous ionizing radiation
Calcification
Psammoma bodies
Cervical mets
Lymphatic spread
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11
Q

Follicular carcinoma buzzwords?

A

Follicles with colloid

Capsular invasion

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12
Q

Medullary carcinoma?

A
Parafollicular cells overgrow
Calcitonin 
Amyloid
Hypocalcemia
Anti-calcitonin staining
Hematogenous spread
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13
Q

Anaplastic carcinoma buzzwords?

A

undifferentiated
older patients with previous thyroid cancer
100% mortality
giant, spindle, mixed cells

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14
Q

What branchial arch does thyroid develop from?

A

1 and 2 at foramen cecum

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15
Q

What embryologic layer is thyroid from?

A

Endodermal downgrowth of thyroid epithelium

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16
Q

Where can thyroglossal cysts be found?

A

Anywhere in midline, down to retrosternum

17
Q

Where are the most common thyroglossal cysts?

A
Lingual
Midline neck, C3
Substernal
Lateral
Strumal: heart
Struma ovarii: thyroid in ovary: functional!
18
Q

What is the most common cause of high PTH?

A

Parafollicular adenoma

19
Q

What causes Parathyroid hyperplasia?

A

Low Ca
Renal disease is common
Leads to adenomas

20
Q

What is the histology of a parathyroid adenoma?

A

Lacks normal fat