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==Follicular thyroid carcinoma== | ==Follicular thyroid carcinoma== | ||
===Clinical=== | ===Clinical=== | ||
Medical school memory device ''4 Fs'': | |||
*FNA NOT diagnosable. | *FNA NOT diagnosable. | ||
*Far away mets (sometimes). | *Far away mets (sometimes). | ||
*Female predominant. | *Female predominant. | ||
*Favourable prognosis. | *Favourable prognosis. | ||
Notes: | |||
*Usu. has a hematologic spread. | |||
**PTC usu. spread via lymphatics. | |||
===Microscopic=== | ===Microscopic=== | ||
Features: | Features: | ||
*''' | *Defined by either: | ||
* | *#Invasion through the capsule: | ||
*#*Should be all the way through.<ref>SR. 17 January 2011.</ref> | |||
*#**1/2 does not count. | |||
*#**Fibrous reaction does not count. | |||
*#**"Above the contour" does not count. | |||
*#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. | |||
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. | |||
==Medullary thyroid carcinoma== | ==Medullary thyroid carcinoma== |
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