15.7 Thyroid Neoplasia

Question 1

How do thyroid tumors normally present?

Answer 1

Distinct solitary nodules - more likely to be benign

Question 2

What is the diagnostic test for thyroid tumors?

Answer 2

131 Iodine Uptake Test

Question 3

What will the iodine uptake test show in Graves disease?

Answer 3

Increased uptake

Question 4

What will the iodine uptake test show in adenoma and carcinoma?

Answer 4

Decreased uptake

Question 5

What is the mechanism of biopsying the thyroid?

Answer 5

Fine Needle Aspiration

Question 6

Follicular Adenoma

Answer 6

Benign proliferation of follicles surrounded by a fibrous capsule - usually is non-functional

Question 7

What can follicular adenomas rarely secrete?

Answer 7

Thyroid Hormone

Question 8

What is the most common thyroid carcinoma?

Answer 8

Papillary Carcinoma

Question 9

What is a major risk for papillary carcinoma?

Answer 9

Exposure to ionizing radiation in childhood

Question 10

What is seen on histology of papillary carcinoma?

Answer 10

• Orphan Annie eye nuclei
• Nuclear grooves
• Psamomma bodies

Question 11

Where does papillary carcinoma spread?

Answer 11

Cervical lymph nodes - excellent prognosis

Question 12

Follicular Carcinoma

Answer 12

Malignant proliferation of follicles that is surrounded by fibrous capsule with invasion through the capsule

Question 13

Can fine needle aspiration distiguish follicular adenoma and carcinoma?

Answer 13

No

Question 14

What is the general mechanism of spread of follicular carcinoma?

Answer 14

Hematogenous Spread

Question 15

What are the 4 carcinomas that generally spread hematogenously?

Answer 15

• Renal Cell Carcinoma
• Hepatocellular Carcinoma
• Follicular Carcinoma
• Choriocarcinoma

Question 16

Medullary Carcinoma

Answer 16

Malignant proliferation of parafollicular C cells that lead to high levels of calcitonin that can cause hypocalcemia

Question 17

What is seen on histology of medullary carcinoma?

Answer 17

Malignants cells in an amyloid stroma

Question 18

What are the genes associated with familial medullary carcinoma?

Answer 18

MEN 2A and 2B

Question 19

What mutations is familial medullary carcinoma associated with?

Answer 19

RET oncogene

Question 20

Anaplastic Carcinoma

Answer 20

Undifferentiated malignant tumor of thyroid that invades local structures

Question 21

What are some complications of anapestic carcinoma?

Answer 21

• Dysphagia

- Respiratory Compromise

Question 22

What patient population is anaplastic carcinoma seen in and what is the prognosis?

Answer 22

Elderly - poor prognosis