Thyroid Pathology Flashcards Preview

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Flashcards in Thyroid Pathology Deck (72):
1

Lesion architecture/growth patterns of thyroid lesions

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

2

T/F thyroid lesions with calcifications should be biopsied

T

3

Papillary formation

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

4

T/F multiple/solitary nodules are usually benign

multiple --> usually benign but can have neoplasm in background

5

2 main types of diffuse thyroid enlargements

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

6

Graves Disease: increase/decrease in colloid

decrease

7

Graves Disease: increase/decrease in vascularity

increase

8

Histological features of Graves

follicular hyperplasia, lymphocytic infiltration in stroma

9

T/F there is hyperplasia in hashimotos

F

10

Histologic features of hashimoto's

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

11

T/F atrophic colloid is functional

F

12

Hurthle cell

oncocytic --> metaplastic follicular cell

13

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

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

14

At least ___% of US pop has thyroid nodules.

60%

15

C cells are located in the lateral/medial thyroid

lateral

16

Malignant tumor of c cells

medullary carcinoma

17

C cell hyperplasia is found in _____ syndrome

MEN 2

18

Gross pathology of non toxic goiter

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

19

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

T

20

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

T

21

Histologic features of non toxic nodular goiters

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

22

fibrosis in non toxic nodular goiter

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

23

Most common thyroid neoplasm

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

24

Most common benign thyroid epithelial neoplasm

follicular adenoma --> white circumscribed capsule

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