Thyroid Nodules

Question 1

Benign thyroid neoplasms

Answer 1

adenoma

Question 2

Malignant thyroid neoplasms

Answer 2

• Papillary (85-90%): multifocal, LN
• Follicular/Hurthle (5%): vascular spread
• Anaplastic (<2%): very aggressive
• Medullary (5%): familial
• Lymphoma (rare)
• Sarcoma (rare)
• Metastatic (rare)

Question 3

Thyroid adenoma

Answer 3

Benign neoplasm
Solitary nodule
Follicular / Hurthle cell
DDx: hyperplastic nodule or follicular ca 
Careful evaluation of the capsule

Question 4

2 types of Follicular/Hurthle cell Carcinoma

Answer 4

• Minimally invasive: Vascular or capsular invasion

- Widely invasive: More extensive invasion

Question 5

Papillary Carcinoma

Answer 5

Most common
Well-differentiated
Multifocal
Lymphatic spread
Excellent prognosis

Question 6

Papillary carcinoma path

Answer 6

Papillae with vascular core
Optically clear nuclei
Nuclear pseudoinclusions
Nuclear grooves
Rare or absent mitoses
Psammoma Bodies

Question 7

Anaplastic carcinoma

Answer 7

Older age group (poor survival)
Rapidly growing mass
Necrosis and hemorrhage
3 patterns

Question 8

Three patterns of anaplastic carcinoma

Answer 8

Spindle cell
Giant cells
Squamoid cells

Question 9

Medullary carcinoma

Answer 9

Solid proliferation of cells with granular cytoplasm (C cells)
Highly vascular stroma
Hyalinized collagen and/or amyloid
May have Psammoma bodies

Question 10

Medullary carcinoma Immunostains:

Answer 10

Thyroglobulin -,
Calcitonin +,
Chromogranin +

Question 11

Thyroid gland lymphoma

Answer 11

Background autoimmune thyroiditis
Large fleshy masses
DDx : anaplastic ca of thyroid
Positive LCA, usually B-cell 
Gene rearrangement

Question 12

Look at slide histo

Answer 12

will do