Difference between revisions of "Follicular thyroid carcinoma"
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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=== | ||
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:
- 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.
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)
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