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== | ||
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*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: | 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]]. | *[[Follicular thyroid adenoma]]. | ||
*[[Papillary thyroid carcinoma follicular variant]]. | *[[Papillary thyroid carcinoma follicular variant]]. | ||
*[[Poorly differentiated thyroid carcinoma]]. | |||
===Images=== | ===Images=== | ||
<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> | <gallery> | ||
Image:Metastatic_follicular_thyroid_carcinoma_-_Case_264_(8559837390).jpg | Metastatic FTC. (WC/Yale Rosen) | 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) | Image:Metastatic_follicular_thyroid_carcinoma_-_Case_264_(8558730243).jpg | Metastatic FTC. (WC/Yale Rosen) | ||
</gallery> | </gallery> | ||
www | ====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
Microscopic
Features:
- Defined by either:
- 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.
- Should be all the way through.[1]
- Vascular invasion (all of the following):
- In a small vein (not a capillary), that is outside of the tumour mass.
- Tumour adherent to the side of the vessel.
- Tumour must be re-endothelialized.
- Invasion through the capsule:
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]
- Follicular thyroid adenoma.
- Papillary thyroid carcinoma follicular variant.
- Poorly differentiated thyroid carcinoma.