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Difference between revisions of "Thyroid gland"
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→Papillary thyroid carcinoma: +IHC
(→Riedel thyroiditis: more, +alt. term) |
(→Papillary thyroid carcinoma: +IHC) |
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*Papillae may be seen in Graves disease. | *Papillae may be seen in Graves disease. | ||
===Subtypes of papillary thyroid carcinoma=== | ====Subtypes of papillary thyroid carcinoma==== | ||
There are many. | There are many. | ||
===Papillary thyroid carcinoma tall cell variant=== | =====Papillary thyroid carcinoma tall cell variant===== | ||
====General==== | ======General====== | ||
*~10% of PTC.<ref>{{Ref Sternberg5|505}}</ref> | *~10% of PTC.<ref>{{Ref Sternberg5|505}}</ref> | ||
*Often large > 6 cm. | *Often large > 6 cm. | ||
====Microscopic==== | ======Microscopic====== | ||
Features:<ref name=pmid19373912>{{cite journal |author=Urano M, Kiriyama Y, Takakuwa Y, Kuroda M |title=Tall cell variant of papillary thyroid carcinoma: Its characteristic features demonstrated by fine-needle aspiration cytology and immunohistochemical study |journal=Diagn. Cytopathol. |volume= |issue= |pages= |year=2009 |month=April |pmid=19373912 |doi=10.1002/dc.21086 |url=}}</ref> | Features:<ref name=pmid19373912>{{cite journal |author=Urano M, Kiriyama Y, Takakuwa Y, Kuroda M |title=Tall cell variant of papillary thyroid carcinoma: Its characteristic features demonstrated by fine-needle aspiration cytology and immunohistochemical study |journal=Diagn. Cytopathol. |volume= |issue= |pages= |year=2009 |month=April |pmid=19373912 |doi=10.1002/dc.21086 |url=}}</ref> | ||
*50% of cells with height 2x the width.<ref>[http://pathologyoutlines.com/thyroid.html#tallcellvariant http://pathologyoutlines.com/thyroid.html#tallcellvariant]</ref><ref name=pmid18925842>{{cite journal |author=Ghossein R, Livolsi VA |title=Papillary thyroid carcinoma tall cell variant |journal=Thyroid |volume=18 |issue=11 |pages=1179–81 |year=2008 |month=November |pmid=18925842 |doi=10.1089/thy.2008.0164 |url=}}</ref> | *50% of cells with height 2x the width.<ref>[http://pathologyoutlines.com/thyroid.html#tallcellvariant http://pathologyoutlines.com/thyroid.html#tallcellvariant]</ref><ref name=pmid18925842>{{cite journal |author=Ghossein R, Livolsi VA |title=Papillary thyroid carcinoma tall cell variant |journal=Thyroid |volume=18 |issue=11 |pages=1179–81 |year=2008 |month=November |pmid=18925842 |doi=10.1089/thy.2008.0164 |url=}}</ref> | ||
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*Nuclei ''not'' pseudostratified, if pseudostratified consider ''columnar cell variant''. | *Nuclei ''not'' pseudostratified, if pseudostratified consider ''columnar cell variant''. | ||
===Papillary thyroid carcinoma columnar cell variant=== | =====Papillary thyroid carcinoma columnar cell variant===== | ||
====General==== | ======General====== | ||
Epidemiology: | Epidemiology: | ||
*Poor prognosis. | *Poor prognosis. | ||
*Very rare. | *Very rare. | ||
====Microscopic==== | ======Microscopic====== | ||
Features:<ref name=Ref_Sternberg5_506>{{Ref Sternberg5|506}}</ref> | Features:<ref name=Ref_Sternberg5_506>{{Ref Sternberg5|506}}</ref> | ||
*Elongated nuclei (similar to colorectal adenocarcinoma) - '''key feature'''. | *Elongated nuclei (similar to colorectal adenocarcinoma) - '''key feature'''. | ||
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Image: [http://www3.interscience.wiley.com/cgi-bin/fulltext/75000320/nfig003a?CRETRY=1&SRETRY=0 Columnar variant PTC (wiley.com)]. | Image: [http://www3.interscience.wiley.com/cgi-bin/fulltext/75000320/nfig003a?CRETRY=1&SRETRY=0 Columnar variant PTC (wiley.com)]. | ||
===Papillary thyroid carcinoma follicular variant=== | =====Papillary thyroid carcinoma follicular variant===== | ||
====General==== | ======General====== | ||
*May be confused with follicular carcinoma or follicular adenoma. | *May be confused with follicular carcinoma or follicular adenoma. | ||
====Microscopic==== | ======Microscopic====== | ||
Features: | Features: | ||
*Prominent follicles. | *Prominent follicles. | ||
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*+/-Capsule. | *+/-Capsule. | ||
===Papillary thyroid carcinoma cribriform-morular variant=== | =====Papillary thyroid carcinoma cribriform-morular variant===== | ||
====General==== | ======General====== | ||
*Associated with [[familial adenomatous polyposis]] (FAP).<ref name=pmid18612695>{{cite journal |author=Groen EJ, Roos A, Muntinghe FL, ''et al.'' |title=Extra-intestinal manifestations of familial adenomatous polyposis |journal=Ann. Surg. Oncol. |volume=15 |issue=9 |pages=2439–50 |year=2008 |month=September |pmid=18612695 |pmc=2518080 |doi=10.1245/s10434-008-9981-3 |url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2518080/?tool=pubmed}}</ref> | *Associated with [[familial adenomatous polyposis]] (FAP).<ref name=pmid18612695>{{cite journal |author=Groen EJ, Roos A, Muntinghe FL, ''et al.'' |title=Extra-intestinal manifestations of familial adenomatous polyposis |journal=Ann. Surg. Oncol. |volume=15 |issue=9 |pages=2439–50 |year=2008 |month=September |pmid=18612695 |pmc=2518080 |doi=10.1245/s10434-008-9981-3 |url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2518080/?tool=pubmed}}</ref> | ||
====Microscopic==== | ======Microscopic====== | ||
Features: | Features: | ||
*Cribriform architectural pattern. | *Cribriform architectural pattern. | ||
*Morules - balls of tissue. | *Morules - balls of tissue. | ||
===Papillary thyroid carcinoma diffuse sclerosing variant=== | =====Papillary thyroid carcinoma diffuse sclerosing variant===== | ||
====General==== | ======General====== | ||
*Usually young adults, children. | *Usually young adults, children. | ||
====Microscopic==== | ======Microscopic====== | ||
Features:<ref>{{Ref PBoD8|1122}}</ref> | Features:<ref>{{Ref PBoD8|1122}}</ref> | ||
*Papillae - usu. prominent. | *Papillae - usu. prominent. | ||
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*Lymphocytic thyroiditis (esp. Hashimoto's thyroiditis). | *Lymphocytic thyroiditis (esp. Hashimoto's thyroiditis). | ||
===Papillary thyroid carcinoma warthin-like variant=== | =====Papillary thyroid carcinoma warthin-like variant===== | ||
*Resemble [[Warthin tumour]]. | *Resemble [[Warthin tumour]]. | ||
====Microscopic==== | ======Microscopic====== | ||
Features:<ref name=Ref_Sternberg5_506>{{Ref Sternberg5|506}}</ref> | Features:<ref name=Ref_Sternberg5_506>{{Ref Sternberg5|506}}</ref> | ||
*Eosinophilic cytoplasm. | *Eosinophilic cytoplasm. | ||
*Lymphocytic thyroiditis. | *Lymphocytic thyroiditis. | ||
*Papillae. | *Papillae. | ||
===IHC=== | |||
*Thyroglobulin +ve. | |||
*TTF-1 (thyroid transcription factor-1) +ve. | |||
*CD15 +ve. (???) | |||
==Insular carcinoma== | ==Insular carcinoma== | ||