Find information on thousands of medical conditions and prescription drugs.

Thyroid cancer

Thyroid cancer is cancer of the thyroid gland. There are four forms: papillary, follicular, medullary and anaplastic. The most common forms (papillary and follicular) are fairly benign, and the medullary form also has a good prognosis; the anaplastic form is fast-growing and poorly responsive to therapy. more...

Home
Diseases
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
Candidiasis
Tachycardia
Taeniasis
Talipes equinovarus
TAR syndrome
Tardive dyskinesia
Tarsal tunnel syndrome
Tay syndrome ichthyosis
Tay-Sachs disease
Telangiectasia
Telangiectasia,...
TEN
Teratoma
Teratophobia
Testotoxicosis
Tetanus
Tetraploidy
Thalassemia
Thalassemia major
Thalassemia minor
Thalassophobia
Thanatophobia
Thoracic outlet syndrome
Thrombocytopenia
Thrombocytosis
Thrombotic...
Thymoma
Thyroid cancer
Tick paralysis
Tick-borne encephalitis
Tietz syndrome
Tinnitus
Todd's paralysis
Topophobia
Torticollis
Touraine-Solente-Golé...
Tourette syndrome
Toxic shock syndrome
Toxocariasis
Toxoplasmosis
Tracheoesophageal fistula
Trachoma
Transient...
Transient Global Amnesia
Transposition of great...
Transverse myelitis
Traumatophobia
Treacher Collins syndrome
Tremor hereditary essential
Trichinellosis
Trichinosis
Trichomoniasis
Trichotillomania
Tricuspid atresia
Trigeminal neuralgia
Trigger thumb
Trimethylaminuria
Triplo X Syndrome
Triploidy
Trisomy
Tropical sprue
Tropophobia
Trypanophobia
Tuberculosis
Tuberous Sclerosis
Tularemia
Tungiasis
Turcot syndrome
Turner's syndrome
Typhoid
Typhus
Tyrosinemia
U
V
W
X
Y
Z
Medicines

Masses of the thyroid are diagnosed by fine needle aspiration (FNA) or frequently by thyroidectomy (surgical removal and subsequent pathological examination). As the thyroid concentrates iodine, radioactive iodine is a commonly used modality in thyroid carcinomas.

Symptoms

Most often the first symptom of thyroid cancer is a nodule in the thyroid region of the neck, but only 4% of these nodules are malignant. Sometimes the first sign is an enlarged lymph node. Other symptoms that can be present are pain, changes in voice and symptoms of hypo- or hyperthyroidism.

Diagnosis

After a nodule is found during a physical examination, thyroid function is investigated by measuring, among other markers, Thyroid Stimulating hormone (TSH), the thyroid hormones thyroxine (T4) and triiodothyronine (T3), and Thyroid Binding Globulin (TBG). Tests for serum thyroid autoantibodies are also sometimes done. The blood assays are usually accompanied by ultrasound imaging of the nodule to determine the position, size and texture. Most clinicians will also request technetium and/or radioactive iodine imaging of the thyroid. The most cost-effective, sensitive and accurate test to determine whether the nodule is malignant is the fine needle biopsy, which is almost always done. Often, the suspected nodule is removed surgically for pathological examination, or a biopsy is done using a coarse needle, so that the arrangement of the cells can be examined (where the fine needle biopsy can only give individual cells).

Read more at Wikipedia.org


[List your site here Free!]


Papillary thyroid carcinoma
From Ear, Nose & Throat Journal, 10/1/04 by Brenda L. Nelson

Papillary thyroid carcinoma is the most common type of thyroid malignancy. The minor occurs largely in adults, usually those between the ages of 20 and 50 years; the female-to-male ratio is 4:1. Papillary thyroid carcinoma is also the most common pediatric thyroid malignancy.

There is a known etiologic link between this malignancy and exposure to radiation, either environmental or therapeutic. Most patients present clinically with a mass, although incidental or un suspected tumors are commonly identified. Because most papillary carcinomas are nonfunctional and findings on radiography are nonspecific, fine-needle aspiration plays an important role in the initial evaluation of any thyroid nodule and as a guide to subsequent therapy.

Papillary carcinoma exhibits a wide variety of macroscopic patterns and sizes. Tumors can appear as encapsulated masses with irregular and sclerotic borders, they can infiltrate into the surrounding parenchyma, and they frequently demonstrate multifocality. The masses are usually firm and gray-white, and dystrophic calcification is common. Direct extension beyond the thyroid capsule is uncommon.

An aggregate of architectural and cytomorphologic criteria is necessary to establish a diagnosis of papillary carcinoma, but there is no consensus as to how many features are requisite. Among the characteristics of papillary carcinoma:

* capsular or vascular invasion

* variable growth patterns (follicular, solid, trabecular, and cystic)

* elongated and/or twisted follicles

* complex, arborizing papillary structures (figure 1)

[FIGURE 1 OMITTED]

* intratumoral acellular fibrosis

* "bright" colloid

* squamous metaplasia

* enlarged cells with a high nuclear-to-cytoplasmic ratio

* nuclear overlapping or crowding

* pale chromatin with chromatin margination/ condensation and clearing (Orphan Annie nuclei)

* nuclear grooves and folds

* intranuclear cytoplasmic inclusions (figure 2, A)

[FIGURES 2 OMITTED]

* calcospherites (psammoma bodies i.e., concentrically laminated calcium deposits) (figure 2, B)

* occasional giant cells within the colloid and crystals (figure 2, C)

There are numerous variants of papillary thyroid carcinoma:

* follicular

* macrofollicular

* oncocytic

* clear-cell

* diffuse sclerosing

* tall-cell

* columnar

* solid

Size is also taken into consideration; tumors smaller than 1 cm are classified as microscopic. More than 95% of tumors are classified as well differentiated. Tumor cells are immunoreactive with thyroglobulin and thyroid transcription factor-1.

Many neoplasms are considered in the differential diagnosis, but the principal ones are follicular adenoma, follicular carcinoma, and medullary carcinoma; nonneoplastic considerations are diffuse hyperplasia (Graves' disease) and adenomatoid nodules.

Papillary carcinoma tends to spread via lymphatic channels, and regional lymph node metastasis is not uncommon. The treatment of papillary thyroid carcinoma is controversial, ranging from lobectomy alone to total thyroidectomy with or without radioactive ablation. Irrespective of treatment, the overall prognosis is excellent, as the 10-year survival rate exceeds 95%.

Suggested reading

LiVolsi VA, Albores-Saavedra J, Asa SL, et al. Papillary carcinoma. In: DeLellis RA, Lloyd R, LiVolsi VA, Eng C, eds. Pathology and Genetics of Turnouts of the Endocrine Organs and Paraganglia. World Health Organization Classification of Tumours. Lyon, France: IARC Press, 2004, 57-66.

LiVolsi VA. Unusual variants of papillary thyroid carcinoma. Adv Endocrinol Metab 1995;6:39-54.

From the Department of Pathology, Woodland Hills Medical Center, Southern California Permanente Medical Group, Woodland Hills, Calif.

COPYRIGHT 2004 Medquest Communications, LLC
COPYRIGHT 2004 Gale Group

Return to Thyroid cancer
Home Contact Resources Exchange Links ebay