Thyroid Path Note

thyroid anatomy

butterfly-shaped, follicular cells and C cells, front of neck beneath larynx over trachea

epidemiology & etiology

2% all cancer 96% endocrine cancers, prior radiation exposure link

most common histopathology of thyroid cancer

papillary 80-90%

histopathologies

papillary & mixed papillary, follicular, medullary, & anaplastic

papillary & mixed papillary pathology

previously irradiated, excellent prognosis, slow growing, women 40-50s, 80% thyroid ca. in children

follicular patho

15-30% thyroid ca, women, children rare

medullary patho

5-10% thyroid ca., 80% spontaneous

anaplastic patho

aggressive, 10% thyroid ca., worst prognosis, <1 year life expectancy

signs & symptoms

palpable neck mass, usually asymptomatic, pain, dysphagia, hoarseness

thyroid lymph

internal jugular, retropharyngeal, pretracheal

most important d&d for thyroid

biopsy

radioactive iodine involvement

I-131, po small dose, destroy thyroid cancer cells anywhere

papillary & mixed pap-follicular spread

regional lymph nodes

follicular spread

mets to bone, liver, & brain