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

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

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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