Follicular thyroid adenoma: Difference between revisions
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Follicular adenoma -- low mag.jpg | |||
| Width = | |||
| Caption = Follicular adenoma. [[H&E stain]]. | |||
| Synonyms = follicular adenoma | |||
| Micro = cellular appearance (low magnification), microfollicles, thick fibrous capsule without invasion, negative for nuclear features of papillary thyroid carcinoma | |||
| Subtypes = | |||
| LMDDx = [[thyroid gland nodular hyperplasia]], [[follicular thyroid carcinoma]], [[noninvasive follicular thyroid neoplasm with papillary-like nuclear features]] (NIFTP), [[Papillary thyroid carcinoma follicular variant]] | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = lesion with thick capsule | |||
| Grossing = | |||
| Staging = | |||
| Site = [[thyroid gland]] | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = | |||
| Signs = thyroid mass | |||
| Symptoms = | |||
| Prevalence = uncommon | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = benign | |||
| Other = | |||
| ClinDDx = [[follicular carcinoma]], other thyroid tumours | |||
| Tx = excision to exclude carcinoma | |||
}} | |||
'''Follicular thyroid adenoma''', abbreviated '''FTA''', is a benign lesion of the [[thyroid gland]]. | |||
==General== | |||
*Most common neoplasm of thyroid.<ref name=Ref_EP51>{{Ref EP|51}}</ref> | |||
*Encapusled lesion (surrounded by fibrous capsule). | |||
*Cannot be diagnosed on [[thyroid cytopathology|thyroid FNA]], as one cannot exclude invasion through the capsule without examining all of it. | |||
==Gross== | |||
*Thick capsule. | |||
Notes: | |||
*The entire capsule should be submitted.<ref>SR. 17 January 2011.</ref> | |||
**A good start for most thyroid specimens with a thick capsule is 10 blocks. | |||
===Images=== | |||
<gallery> | |||
Image: Follicular Adenoma of the Thyroid Gland (5186991355).jpg | FTA. (WC/Euthman) | |||
</gallery> | |||
==Microsopic== | |||
Features: | |||
*Cellular. | |||
*Thick capsule - '''key feature'''. | |||
Negatives. | |||
*No invasion of the capsule - see [[follicular thyroid carcinoma]]. | |||
*No nuclear features suggestive of [[papillary thyroid carcinoma]]. | |||
DDx: | |||
*[[Thyroid gland nodular hyperplasia]] with an encapsulated nodule - not as cellular. | |||
*[[Follicular thyroid carcinoma]]. | |||
*[[Noninvasive follicular thyroid neoplasm with papillary-like nuclear features]] (NIFTP). | |||
*[[Papillary thyroid carcinoma follicular variant]]. | |||
===Images=== | |||
<gallery> | |||
Image: Follicular adenoma -- extremely low mag.jpg | FA - extremely low mag. (WC) | |||
Image: Follicular adenoma -- very low mag.jpg | FA - very low mag. (WC) | |||
Image: Follicular adenoma -- low mag.jpg | FA - low mag. (WC) | |||
Image: Follicular adenoma -- intermed mag.jpg | FA - intermed. mag. (WC) | |||
Image: Follicular adenoma -- high mag.jpg | FA - high mag. (WC) | |||
Image: Follicular adenoma -- very high mag.jpg | FA - very high mag. (WC) | |||
</gallery> | |||
==Sign out== | |||
<pre> | |||
Left Hemithyroid, Hemithyroidectomy: | |||
- Follicular adenoma. | |||
- Parathyroid gland. | |||
- Five benign lymph nodes (0/5). | |||
- NEGATIVE for evidence of malignancy. | |||
</pre> | |||
===Block letters=== | |||
<pre> | |||
LEFT THYROID, SUPERIOR POLE, EXCISION: | |||
- FOLLICULAR ADENOMA, MAXIMAL DIMENSION 5 MM. | |||
- LYMPHOCYTIC THYROIDITIS. | |||
- NODULAR HYPERPLASIA. | |||
- NEGATIVE FOR MALIGNANCY. | |||
</pre> | |||
===Micro=== | |||
The section shows a well-circumscribed lesion encapsulated by a thick fibrous capsule (~0.4 mm thick). | |||
The lesions consists of microfollicles with a dense appearing colloid. The nuclei have round regular nuclear membranes. Small indistinct nucleoli are seen at high power. | |||
Focally, the lesional cells overlap. However, the chromatin is not cleared. Nuclear grooves are not readily apparent and nuclear pseudoinclusions are not readily identified. | |||
==See also== | |||
*[[Thyroid gland]]. | |||
==References== | |||
{{Reflist|1}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Thyroid gland]] | |||