ENT Flashcards Preview

Anatomic pathology > ENT > Flashcards

Flashcards in ENT Deck (440)
Loading flashcards...
0

Granulomatous thyroiditis:

A. Age group.
B. Symptoms.

A. Middle-aged women.

B. Thyroidal tenderness, fever, sore throat, malaise.

1

Granulomatous thyroiditis: Hormonal status.

Initial phase: T4 and T3 often elevated.

Resolution: Usually euthyroid, but can be hypothyroid.

2

Granulomatous thyroiditis: Histology (3).

Foreign-body granulomas centered on follicles.

Giant cells with ingested colloid; neutrophils early; mononuclear cells.

Variable fibrosis.

3

Granulomatous thyroiditis vs. sarcoidosis.

Sarcoidosis: Granulomas are in the interstitium rather than centered on follicles.

4

Granulomatous thyroiditis vs. fungal thyroiditis.

Fungal thyroiditis: Usually acute inflammation with necrosis; granulomas are less frequent.

5

Granulomatous thyroiditis vs. Hashimoto's thyroiditis.

Hashimoto's thyroiditis:

- Germinal centers.
- Oncocytic change.

6

Granulomatous thyroiditis vs. palpation thyroiditis.

Palpation thyroiditis:

- Fewer giant cells and mononuclear cells within thyroid follicles.
- No neutrophils.

7

Hashimoto's thyroiditis:

A. Geography.
B. Associated HLA types.

A. Areas with abundant iodine.

B. DR3, DR5.

8

Hashimoto's thyroiditis: Associated genetic diseases (3).

Turner's syndrome.

Down's syndrome.

Familial Alzheimer's disease.

9

Hashimoto's thyroiditis: Pitfalls in diagnosis (2).

Parasitic nodules may be confused with nodal metastases.

Optically clear nuclei may be overdiagnosed as papillary thyroid carcinoma.

10

Hashimoto's thyroiditis: Lymphocytes.

Mixture of B and T cells.

11

Hashimoto's thyroiditis vs. nonspecific lymphocytic thyroiditis (3).

Nonspecific lymphocytic thyroiditis:

− Fewer germinal centers.
− No oncocytic change.
− Minimal fibrosis.

12

Riedel's thyroiditis:

A. Age group.
B. Associated fibrosing disorders (3).

A. Peak in the fifth decade.

B. Mediastinal fibrosis; retroperitoneal fibrosis; sclerosing cholangitis.

13

Riedel's thyroiditis: Inflammation.

Lymphocytes, plasma cells, neutrophils, histiocytes, eosinophils.

No giant cells, no germinal centers.

14

Riedel's thyroiditis: Vascular change.

"Occlusive phlebitis": Lymphocytes and plasma cells cause thickened wall and myxoid change.

15

Riedel's thyroiditis vs. undifferentiated thyroid carcinoma.

The carcinoma contains scattered malignant cells; IHC may help.

16

Riedel's thyroiditis:

A. Treatment.
B. Outcome.

A. Corticosteroids or tamoxifen; surgery as needed.

B. Hypothyroidism in half of cases.

17

Graves' disease: Associated HLA types.

DR3, B8.

18

Histology of Graves' disease:

A. Untreated.
B. After treatment with radioactive iodine.

A. Hyperplastic thyroid follicles with decreased colloid; variable lymphocytic inflammation.

B. Nuclear atypia, stromal fibrosis, more colloid.

19

Amyloid goiter:

A. Location of amyloid.
B. Other histologic features (2).

A. Around vessels and between thyroid follicles.

B. Squamous metaplasia, secondary atrophy of follicles.

20

Dyshormogenetic goiter: Most common functional defect.

Inability to incorporate iodine.

21

Dyshormogenetic goiter: Most commonly associated malignancy.

Follicular carcinoma.

22

Dyshormogenetic goiter: Gross appearance.

Enlarged, nodular thyroid gland.

23

Dyshormogenetic goiter: Histologic architecture (2).

Small follicles contain scant colloid and form clusters that are separated from one another by fibrous bands.

Follicular cells may form papillae.

24

Dyshormogenetic goiter: Cytology.

Often hypercellular and pleomorphic.

25

Thyroglossal-duct cyst:

A. Lining epithelium.
B. Stroma.

A. Respiratory or squamous.

B. Mucus glands and thyroid follicles.

26

Thyroglossal-duct cyst: Most commonly associated malignancy.

Papillary thyroid carcinoma.

27

Causes of finding of ciliated cells on FNA of the thyroid gland (2).

Thyroglossal-duct cyst.

Tracheal aspirate.

28

Branchial-cleft cyst:

A. Anatomic site.
B. Origins (4).

A. Anterolateral neck.

B. 1st, 2nd, 3rd, or 4th branchial pouch.

29

Branchial-cleft cyst: Age group.

Children and young adults.

Unusual in older adults.