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Difference between revisions of "Thyroid gland"
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→Benign: +solid cell nest
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(→Benign: +solid cell nest) |
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=Benign= | =Benign= | ||
==Solid cell nest of thyroid== | |||
===General=== | |||
*Embryonic remnants endodermal origin.<ref name=pmid12527712>{{cite journal |author=Reis-Filho JS, Preto A, Soares P, Ricardo S, Cameselle-Teijeiro J, Sobrinho-Simões M |title=p63 expression in solid cell nests of the thyroid: further evidence for a stem cell origin |journal=Mod. Pathol. |volume=16 |issue=1 |pages=43–8 |year=2003 |month=January |pmid=12527712 |doi=10.1097/01.MP.0000047306.72278.39 |url=http://www.nature.com/modpathol/journal/v16/n1/full/3880708a.html}}</ref> | |||
*Incidental finding. | |||
===Microscopic=== | |||
Features:<ref name=pmid12527712/> | |||
*Solid or cystic cluster or variable size. | |||
*Cuboidal-to-columnar morphology. | |||
*Eosinophilic cytoplasm. | |||
*Round/ovoid nuclei with finely granular chromatin. | |||
*+/-Goblet cells (~30% of cases).<ref name=pmid7509563>{{cite journal |author=Mizukami Y, Nonomura A, Michigishi T, ''et al.'' |title=Solid cell nests of the thyroid. A histologic and immunohistochemical study |journal=Am. J. Clin. Pathol. |volume=101 |issue=2 |pages=186–91 |year=1994 |month=February |pmid=7509563 |doi= |url=}}</ref> | |||
Image: | |||
*[http://www.nature.com/modpathol/journal/v16/n1/fig_tab/3880708f1.html#figure-title Crappy B&W of solid cell nest (nature.com)]. | |||
DDx:<ref name=pmid12527712/> | |||
*C-cell hyperplasia. | |||
*Medullary carcinoma. | |||
*Squamous lesions. | |||
===IHC=== | |||
Features:<ref name=pmid12527712/> | |||
*p63 +ve. | |||
**-ve in clear cells. | |||
*CEA +ve (polyconal).<ref name=pmid7509563>{{cite journal |author=Mizukami Y, Nonomura A, Michigishi T, ''et al.'' |title=Solid cell nests of the thyroid. A histologic and immunohistochemical study |journal=Am. J. Clin. Pathol. |volume=101 |issue=2 |pages=186–91 |year=1994 |month=February |pmid=7509563 |doi= |url=}}</ref> | |||
**+ve also in clear cells. | |||
==Nodular hyperplasia== | ==Nodular hyperplasia== | ||
* | ===General=== | ||
*[[AKA]] ''goitre'', AKA sporadic goitre, AKA multinodular goitre (MNG). | |||
*Most common diagnosis in the thyroid. | |||
**If you've seen a handful of thyroids you've seen this. | **If you've seen a handful of thyroids you've seen this. | ||
*Follicles of variable size. | |||
Notes: | |||
*Large lesions may be clonal; however, this is clinically irrelevant. | |||
===Microscopic=== | |||
Features: | |||
*Follicles of variable size - '''key feature'''. | |||
**Should be obvious at low power, i.e. ~2.5x objective. | |||
*Nodules maybe well circumscribed (on gross), but do not have a thick fibrous capsule. | *Nodules maybe well circumscribed (on gross), but do not have a thick fibrous capsule. | ||
Negatives: | |||
**Not cellular. | *No nuclear features suggestive of malignancy (at lower power). | ||
**One should not look at high power. | |||
*Not cellular. | |||
==Follicular adenoma== | ==Follicular adenoma== | ||