157 Thyroid histo/path Flashcards Preview

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Flashcards in 157 Thyroid histo/path Deck (29):
1

Thyroid
-embryological origin?

1st pharyngeal arch
endodermal origin

2

what connects thyroid to the base of the tongue?

thryoglossal duct - should obliterate during gestation --> if not, pathology as adult

3

do thyroid nodules move with deglutition?

yes

4

Thyroid - histo

capsule penetrates and divides into lobules
20-40 follicles per lobules

5

what surrounds colloid?

simple follicular epithleium

6

what do C-cells secrete? what cancer do they cause?

calcitonin

medullary carcinoma

7

how are thyroid nodules evaluated?

FNA

8

what causes a midline mass superior to the isthmus? histo? treatment?

thyroglossal duct cyst - failure of atrophy

cyst w/ squamous epi filled with proteinaceous fluid

surgery requires removal of hyoid bone (cosmetic surgery)

9

Chronic lymphocytic (Hashimoto) thyroiditis
-cause?

autoimmune abs --> TG and TPO

10

Chronic lymphocytic (Hashimoto) thyroiditis
-macro appearance?

diffusely enlarged gland

11

Chronic lymphocytic (Hashimoto) thyroiditis
-micro appearance?

inflammatory cells with germinal cells
follicles atrophy with Hurthle cells (follicular epi cell regenerate with metaplasia) --> big pink cells with lots of mitochondria

12

Chronic lymphocytic (Hashimoto) thyroiditis
-risk?

other autoimmune disease
b-cell non-hodgkin lymphomas

13

Graves’ Disease - cause

autoimmune Abs against TSH receptor --> activating (hyperthyroidism)

14

Graves’ Disease - presentation

hyperplasia of gland - diffuse enlargement
ophthalmopathy - eyes are large
dermatopathy - skin changes

15

Graves’ Disease - treamtent

1st - radioactive
if fail - surgery

16

Graves disease - micro histo

papillary hyperplasia with tall follicular cells

lack nuclear features of papillary carcinoma

17

Adenomatous/Colloid/ Hyperplastic Nodule

benign hyperplastic nodule/goiter

18

Adenomatous/Colloid/ Hyperplastic Nodule - single or multiple

usually multiple

19

Adenomatous/Colloid/ Hyperplastic Nodule - histo

hyperplastic --> outgrow vasculature --> necrosis and hemorrhage --> dystrophic calcification --> involution

repeat cycles of hyperplasia and involtion --> nodules

20

Thyroid Neoplasms

adenomas = benign
carcinoma = malignant

21

Follicular/Hurthle Cell Adenoma - mutiple or single nodules?

usually single from follicular epithelium

can't distinguish from follicular carcinomas until excised

22

Follicular/Hurthle Cell Adenoma

intact capsule surrounding small follicles (rosettes) - carcinomas break through capsule and vasculature
(other nodules don't have a capsule)



monoclonial (nodules are often polyclonial)

23

Follicular/Hurthle Cell Carcinoma

capsular invasion
vascular invasion

RAS and PAX8 mutations are common

24

most common thyroid carcinoma? cause? mutations? spread?

papillary carcinoma

radiation

MAP kinase pathway
RET
BRAF activating point mutation

lymph - can be mulitfocal so must take out entire gland with surgey

25

Papillary carcinoma - histo

orphan annie eyes
atypical nuclear morphology
nuclear grooves
intranuclear inclusion
psammaoma body - Ca circles at papilla

26

MTC - cell type? mutation?

C-cells

can occur with MEN 2A/2B

RET

27

MTC appearance

non-encapsulated
middle to upper thyroid lobes

28

what tyroid cancer has the worst prognosis?

anaplasitic (undifferentiated) carcinoma

29

Thyroid Lymphoma

usually NHL, B cell type

usually in setting of Hashimoto's