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Endocrine > Thyroid Pathology > Flashcards

Thyroid Pathology Flashcards

1
Q

Lesion architecture/growth patterns of thyroid lesions

A

follicular, papillary, solid, trabecular w/ fibrosis, calcifications, or amyloid

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2
Q

T/F thyroid lesions with calcifications should be biopsied

A

T

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3
Q

Papillary formation

A

hyperplastic proliferation of follicular epithelium results in invagination of cells into lumen of follicle –> VEGF mediated central blood supply –> papillary formation

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4
Q

T/F multiple/solitary nodules are usually benign

A

multiple –> usually benign but can have neoplasm in background

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5
Q

2 main types of diffuse thyroid enlargements

A

hyper: diffuse toxic goiter (Graves)
hypo: chronic lymphocytic thyroiditis (Hashimoto’s)

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6
Q

Graves Disease: increase/decrease in colloid

A

decrease

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7
Q

Graves Disease: increase/decrease in vascularity

A

increase

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8
Q

Histological features of Graves

A

follicular hyperplasia, lymphocytic infiltration in stroma

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9
Q

T/F there is hyperplasia in hashimotos

A

F

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10
Q

Histologic features of hashimoto’s

A

infiltration of lymphocytes and plasma cells, follicular atrophy, oncocytic metaplasia

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11
Q

T/F atrophic colloid is functional

A

F

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12
Q

Hurthle cell

A

oncocytic –> metaplastic follicular cell

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13
Q

T/F lymphocytic metaplasia in hashimoto’s is limited to stroma

A

F –> throughout gland vs. only in stroma in Graves

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14
Q

At least ___% of US pop has thyroid nodules.

A

60%

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15
Q

C cells are located in the lateral/medial thyroid

A

lateral

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16
Q

Malignant tumor of c cells

A

medullary carcinoma

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17
Q

C cell hyperplasia is found in _____ syndrome

A

MEN 2

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18
Q

Gross pathology of non toxic goiter

A

firm, diffusely enlarged –> rough multinodular, calcification, fibrosis, cystic degeneration

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19
Q

T/F calcifications can be found in benign and malignant nodules

A

T

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20
Q

T/F non toxic nodular goiters are non-heterogeneous on histologic exam

A

T

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21
Q

Histologic features of non toxic nodular goiters

A

large and small follicles, columnar or cuboidal epithelium, follicular hyperplasia/papillary growth, fibrosis

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22
Q

fibrosis in non toxic nodular goiter

A

thyroid nodules outgrow blood supply –> degeneration of nodules –> fibrosis

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23
Q

Most common thyroid neoplasm

A

well-differentiated thyroid neoplasm –> same architecture (follicles and papillae) –> still produce Tg

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24
Q

Most common benign thyroid epithelial neoplasm

A

follicular adenoma –> white circumscribed capsule

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25
Malignant tumors of thyroid are more common in M/F
F --> nodules in general more common in women
26
Most thyroid carcinomas are indolent/aggressive
indolent --> can treat with radioactive iodine b/c well differentiated still can absorb iodine and have functional receptors
27
Most well known etiological factor for thyroid carcinoma
irradiation especially in childhood (Chernobyl) leading to papillary carcinoma
28
Which gene rearrangements are common to irradiation of thyroid
Ret oncogene (in addition to RAS, BRAF, p53, APC)
29
Which carcinoma is the primary result of thyroid irradiation
Papillary carcinoma (well differentiated malignant neoplasm of thyroid)
30
T/F thyroid carcinoma due to irradiation can result from mutations
F --> rearrangements
31
RET
rearranged in endocrine tumors --> chimeric oncogene on chr10 --> overactivation of tk domain
32
T/F RET/PTC is specific to papillary thyroid carcinoma
T
33
Two main well differentiated follicular cell carcinomas
PTC, follicular carcinomas
34
PTC is common to iodine sufficient/deficient regions
sufficient
35
PTC are known as micro/macro carcinomas
micro
36
T/F 30% of US pop has a microcarcinoma in thyroid
T
37
Where does PTC metastasize to?
lymph nodes
38
Dx of PTC
nuclear features NOT invasive growth
39
Histologic features of PTC
nuclear inclusion/groove, elongated cells, clear nuclei
40
Tall cells
tall cell variant of PTC has really tall cells
41
Variants of PTC
papillary, follicular, tall cell
42
10 year survival of PTC
90%
43
Risk factors for PTC aggressive growth
male, older age, tall cell, distant mets
44
Follicular carcinoma is common in iodine deficient/sufficient areas
deficient
45
T/F follicular carcinoma shows up with older age
T
46
T/F PTC can present at all ages
T
47
T/F Follicular carcinoma are encapsulated
T --> like an adenoma except with invasion of tumor capsule and capsule vessels
48
How does Follicular carcinoma metastasize
hematogenous spread
49
Papillary or Follicular? most common thyroid cancer
papillary
50
Papillary or Follicular? Dx based on nuclear morphology
papillary
51
Papillary or Follicular? dx based on invasion
follicular
52
Papillary or Follicular? mets via lymph
PTC
53
Papillary or Follicular? mets via blood
follicular
54
Papillary or Follicular? multiple tumors
PTC
55
Papillary or Follicular? single tumor
follicular
56
Papillary or Follicular? ras mutations
follicular
57
Papillary or Follicular? ret mutations
PTC
58
c cell derived carcinoma
medullary carcinoma
59
Medullary carcinoma involves mutations of _____ oncogene
Ret
60
Tumor nest
pathologic feature of medullary carcinoma with amyloid background
61
Medullary carcinoma produces ____
calcitonin
62
T/F can treat medullary carcinoma with radioactive iodine
F
63
5 year prognosis of medullary carcinoma
50%
64
Amyloid in thyroid indicates ____
medullary carcinoma --> byproduct of calcitonin production
65
Medullary carcinoma metastasizes via
blood and lymph
66
Dx medullary carcinoma
cytology or calcitonin stain or measure calcitonin levels
67
Anaplastic carcinoma of thyroid
fatal, 5% of thyroid malignancies, pt's over 60
68
Most aggressive tumor of thyroid/body
anaplastic carcinoma
69
T/F anaplastic carcinoma often preceded by hx of goiter
T --> multinodular more common
70
Anaplastic carcinoma more common in M/F
F
71
T/F Anaplastic carcinomas can be treated with radioactive iodine
F --> not well differentiated and does not produce Tg
72
Histology of anaplastic carcinoma
Multinucleated giant cells, pleomorphic, spindle cells

Endocrine (26 decks)

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