Pathology - Thyroid Carcinoma
Linked to radiation exposure to the head/neck or a genetic tendency for thyroid cancer. Thyroid: Firm nodules present. Microscopic: Four histological kinds. (1) Follicular: tiny, homogeneous follicles packed with colloid. (2) Papillary thyroid cancer: accounts for 75%-80% of cases, characterized by papillae made of cuboidal cells, Orphan Annie nuclei, and psammoma bodies; (3) Medullary thyroid cancer: originates from C cells, forming nests of cells surrounded by amyloid deposits; (4) Anaplastic thyroid cancer: has pleomorphic large cells, spindle cells, and small anaplastic cells. Presence of a painless lump in the neck, which may cause difficulty swallowing or hoarseness due to local pressure; thyroid function tests often show normal results. Papillary cancer spreads to nearby lymph nodes. Follicular cancer spreads to the lung and bone through the bloodstream. Medullary gland secretes calcitonin and is linked to Multiple Endocrine Neoplasia type IIA and IIB. Treatment options include thyroidectomy, lobectomy, and radioactive iodine treatment. Papillary thyroid cancer has a favorable prognosis, while anaplastic thyroid cancer has a notably unfavorable prognosis. Thyroid adenomas are prevalent. Microscopically, they consist of consistent follicles filled with colloid, although having different histologic variations. They are not deemed precancerous and typically do not perform any function.
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