Difference between revisions of "Follicular thyroid carcinoma"

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{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Follicular thyroid carcinoma 2 - alt -- low mag.jpg
| Width      =
| Caption    = [[Micrograph]] showing a follicular thyroid carcinoma. [[H&E stain]].
| Synonyms  =
| Micro      = bland thyroid cells invading through the (fibrous) capsule or lymphovascular invasion or distal metastases
| Subtypes  =
| LMDDx      = [[follicular thyroid adenoma]],  [[papillary thyroid carcinoma follicular variant]]
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Staging    =
| Site      = [[thyroid gland]]
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      = thyroid nodule/mass
| Symptoms  =
| Prevalence = uncommon, female predominant
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = good
| Other      =
| ClinDDx    =
| Tx        = surgical excision
}}
'''Follicular thyroid carcinoma''', abbreviated '''FTC''', is an uncommon malignancy of the [[thyroid gland]]. It is also known as ''follicular carcinoma''.
'''Follicular thyroid carcinoma''', abbreviated '''FTC''', is an uncommon malignancy of the [[thyroid gland]]. It is also known as ''follicular carcinoma''.
==General==
==General==
*Usually spread by the hematologic route.
**PTC usually spreads via lymphatics.
===Clinical===
===Clinical===
Medical school memory device ''4 Fs'':
Medical school memory device ''4 Fs'':
Line 8: Line 43:
*Favourable prognosis.
*Favourable prognosis.


Notes:
==Gross==
*Usu. has a hematologic spread.
*Encapuslated lesion +/-evidence of invasion through the capsule.
**PTC usu. spread via lymphatics.
 
===Images===
<gallery>
Image: Follicular adenoma of the thyroid.jpg | FTC - gross. (WC/Euthman)
</gallery>


==Microscopic==
==Microscopic==
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*'''Impossible''' to differentiate from ''[[follicular thyroid adenoma|follicular adenoma]]'' on FNA (no cytologic differences).
*'''Impossible''' to differentiate from ''[[follicular thyroid adenoma|follicular adenoma]]'' on FNA (no cytologic differences).
*Described as "over-diagnosed" ... misdiagnoses: PTC follicular variant, follicular adenoma, multinodular goitre with a thick capsule.
*Described as "over-diagnosed" ... misdiagnoses: PTC follicular variant, follicular adenoma, multinodular goitre with a thick capsule.
DDx:<ref name=pmid21455197>{{Cite journal  | last1 = Sobrinho-Simões | first1 = M. | last2 = Eloy | first2 = C. | last3 = Magalhães | first3 = J. | last4 = Lobo | first4 = C. | last5 = Amaro | first5 = T. | title = Follicular thyroid carcinoma. | journal = Mod Pathol | volume = 24 Suppl 2 | issue =  | pages = S10-8 | month = Apr | year = 2011 | doi = 10.1038/modpathol.2010.133 | PMID = 21455197 }}</ref>
*[[Follicular thyroid adenoma]].
*[[Papillary thyroid carcinoma follicular variant]].
*[[Poorly differentiated thyroid carcinoma]].


===Images===
===Images===
www:
<gallery>
Follicular thyroid carcinoma -- very low mag.jpg | FTC - very low mag.
Follicular thyroid carcinoma -- low mag.jpg | FTC - low mag.
Follicular thyroid carcinoma -- intermed mag.jpg | FTC - intermed. mag.
Follicular thyroid carcinoma -- high mag.jpg | FTC - high mag.
Follicular thyroid carcinoma - alt -- high mag.jpg | FTC - high mag.
 
Follicular thyroid carcinoma 2 -- very low mag.jpg | FTC - very low mag.
Follicular thyroid carcinoma 2 -- low mag.jpg | FTC - low mag.
Follicular thyroid carcinoma 2 - alt -- low mag.jpg | FTC - low mag.
Follicular thyroid carcinoma 2 -- intermed mag.jpg | FTC - intermed. mag.
Follicular thyroid carcinoma 2 - alt -- intermed mag.jpg | FTC - intermed. mag.
Follicular thyroid carcinoma 2 -- high mag.jpg | FTC - high mag.
</gallery>
<gallery>
Image:Metastatic_follicular_thyroid_carcinoma_-_Case_264_(8559837390).jpg | Metastatic FTC. (WC/Yale Rosen)
Image:Metastatic_follicular_thyroid_carcinoma_-_Case_264_(8558730243).jpg | Metastatic FTC. (WC/Yale Rosen)
</gallery>
====www====
*[http://path.upmc.edu/cases/case653.html Follicular thyroid carcinoma - several images (upmc.edu)].
*[http://path.upmc.edu/cases/case653.html Follicular thyroid carcinoma - several images (upmc.edu)].


Latest revision as of 09:25, 11 September 2018

Follicular thyroid carcinoma
Diagnosis in short

Micrograph showing a follicular thyroid carcinoma. H&E stain.
LM bland thyroid cells invading through the (fibrous) capsule or lymphovascular invasion or distal metastases
LM DDx follicular thyroid adenoma, papillary thyroid carcinoma follicular variant
Site thyroid gland
Signs thyroid nodule/mass
Prevalence uncommon, female predominant
Prognosis good
Treatment surgical excision

Follicular thyroid carcinoma, abbreviated FTC, is an uncommon malignancy of the thyroid gland. It is also known as follicular carcinoma.

General

  • Usually spread by the hematologic route.
    • PTC usually spreads via lymphatics.

Clinical

Medical school memory device 4 Fs:

  • FNA NOT diagnosable.
  • Far away mets (sometimes).
  • Female predominant.
  • Favourable prognosis.

Gross

  • Encapuslated lesion +/-evidence of invasion through the capsule.

Images

  • FTC - gross. (WC/Euthman)

Microscopic

Features:

  • Defined by either:
    1. Invasion through the capsule:
      • Should be all the way through.[1]
        • 1/2 does not count.
        • Fibrous reaction does not count.
        • "Above the contour" does not count.
    2. Vascular invasion (all of the following):
      1. In a small vein (not a capillary), that is outside of the tumour mass.
      2. Tumour adherent to the side of the vessel.
      3. Tumour must be re-endothelialized.

Notes:

  • Impossible to differentiate from follicular adenoma on FNA (no cytologic differences).
  • Described as "over-diagnosed" ... misdiagnoses: PTC follicular variant, follicular adenoma, multinodular goitre with a thick capsule.

DDx:[2]

Images

  • FTC - very low mag.

  • FTC - low mag.

  • FTC - intermed. mag.

  • FTC - high mag.

  • FTC - high mag.

  • FTC - very low mag.

  • FTC - low mag.

  • FTC - low mag.

  • FTC - intermed. mag.

  • FTC - intermed. mag.

  • FTC - high mag.

  • Metastatic FTC. (WC/Yale Rosen)

  • Metastatic FTC. (WC/Yale Rosen)

www

See also

References

  1. ↑ SR. 17 January 2011.
  2. ↑ Sobrinho-Simões, M.; Eloy, C.; Magalhães, J.; Lobo, C.; Amaro, T. (Apr 2011). "Follicular thyroid carcinoma.". Mod Pathol 24 Suppl 2: S10-8. doi:10.1038/modpathol.2010.133. PMID 21455197.
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