Difference between revisions of "Thyroid gland"

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634 bytes added ,  21:01, 17 January 2011
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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:
*'''IMPOSSIBLE''' to differentiate from ''follicular adenoma'' on FNA (no cytologic differences).
*Defined by either:
*Defined by invasion through the capsule.
*#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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