Thyroid nodules and thyroid cancer: Pathology review
7,978views
00:00 / 00:00
Videos
Notes
Thyroid nodules and thyroid cancer: Pathology review
Endocrine system
Adrenal gland disorders
Congenital adrenal hyperplasia
Primary adrenal insufficiency
Waterhouse-Friderichsen syndrome
Hyperaldosteronism
Adrenal cortical carcinoma
Cushing syndrome
Conn syndrome
Thyroid gland disorders
Thyroglossal duct cyst
Hyperthyroidism
Graves disease
Thyroid eye disease (NORD)
Toxic multinodular goiter
Thyroid storm
Hypothyroidism
Euthyroid sick syndrome
Hashimoto thyroiditis
Subacute granulomatous thyroiditis
Riedel thyroiditis
Postpartum thyroiditis
Thyroid cancer
Parathyroid gland disorders
Hyperparathyroidism
Hypoparathyroidism
Hypercalcemia
Hypocalcemia
Pancreatic disorders
Diabetes mellitus
Diabetic retinopathy
Diabetic nephropathy
Pituitary gland disorders
Hyperpituitarism
Pituitary adenoma
Hyperprolactinemia
Prolactinoma
Gigantism
Acromegaly
Hypopituitarism
Growth hormone deficiency
Pituitary apoplexy
Sheehan syndrome
Hypoprolactinemia
Constitutional growth delay
Diabetes insipidus
Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
Gonadal dysfunction
Precocious puberty
Delayed puberty
Premature ovarian failure
Polycystic ovary syndrome
Androgen insensitivity syndrome
Kallmann syndrome
5-alpha-reductase deficiency
Polyglandular syndromes
Autoimmune polyglandular syndrome type 1 (NORD)
Endocrine tumors
Multiple endocrine neoplasia
Pancreatic neuroendocrine neoplasms
Zollinger-Ellison syndrome
Carcinoid syndrome
Pheochromocytoma
Neuroblastoma
Opsoclonus myoclonus syndrome (NORD)
Endocrine system pathology review
Adrenal insufficiency: Pathology review
Adrenal masses: Pathology review
Hyperthyroidism: Pathology review
Hypothyroidism: Pathology review
Thyroid nodules and thyroid cancer: Pathology review
Parathyroid disorders and calcium imbalance: Pathology review
Diabetes mellitus: Pathology review
Cushing syndrome and Cushing disease: Pathology review
Pituitary tumors: Pathology review
Hypopituitarism: Pathology review
Diabetes insipidus and SIADH: Pathology review
Multiple endocrine neoplasia: Pathology review
Neuroendocrine tumors of the gastrointestinal system: Pathology review
Assessments
Thyroid nodules and thyroid cancer: Pathology review
USMLE® Step 1 questions
0 / 8 complete
Questions
USMLE® Step 1 style questions USMLE
of complete
Memory Anchors and Partner Content
Transcript
Content Reviewers
Yifan Xiao, MDContributors
Anca-Elena Stefan, MD
Kaylee Neff
Victoria Cumberbatch
Ursula Florjanczyk, MScBMC
On the endocrinology ward, two individuals came in.
Both individuals complained about feeling a lump on their necks, but reports no other symptoms.
The first one is 49 year old Dasha who as a child, lived close to Chernobyl.
The other one is 27 year old Mike, who’s family history involves multiple endocrine neoplasia type 2A.
On exam, they each had a painless mass on their thyroid.
Both people had normal T3, T4, and TSH levels.
They underwent thyroid echography, which showed cold nodules.
Afterwards, fine-needle biopsies were done.
Both individuals had tumors on their thyroids.
First, let’s refresh some info on the thyroid.
The thyroid gland is an endocrine gland located in the neck.
The thyroid gland is made up of thousands of follicles, which are small spheres lined with follicular cells.
Follicular cells convert thyroglobulin, a protein found in follicles, into two iodine-containing hormones, tri-iodo-thyronine or T3, and thyroxine or T4.
Once released from the thyroid gland, these hormones enter the blood and bind to circulating plasma proteins.
Once inside the cell T4 is mostly converted into T3, at which point it can exert its effect.
T3, among other effects, speeds up the basal metabolic rate, increases cardiac output, stimulates bone resorption and activates the sympathetic nervous system.
The thyroid is also made up of parafollicular or C cells, which are near the follicles.
These cells produce calcitonin, a hormone that lowers blood calcium levels by inhibiting osteoclasts.
Calcitonin also inhibits renal tubular cell reabsorption of calcium, allowing the calcium to be excreted in the urine.
Now, DNA mutations can cause thyroid cells to become cancerous.
For example, a mutation might change a proto-oncogenes like RET and BRAF, which are genes that code for proteins that promote cell growth and proliferation, into oncogenes.
Summary
Thyroid nodules are lumps or growths that form in the thyroid gland, which is located in the neck. Thyroid nodules are relatively common and are often benign. They may cause no symptoms and be discovered incidentally during a physical exam or imaging study, or they may cause symptoms such as difficulty swallowing, hoarseness, or a visible lump in the neck.
Thyroid cancers, on the other hand, are less common than benign thyroid nodules, but the incidence of thyroid cancer has been increasing in recent years. There are several types of thyroid cancer, including papillary thyroid cancer, follicular thyroid cancer, medullary thyroid cancer, and anaplastic thyroid cancer.
The risk factors for thyroid cancer include a family history of thyroid cancer, radiation exposure, and certain genetic syndromes. Symptoms of thyroid cancer can vary, but may include pain in the neck or throat, difficulty swallowing or breathing, and hoarseness. Treatment for thyroid cancer depends on the specific type and stage of the condition. Options may include surgery to remove all or part of the thyroid gland, radiation therapy, and medication to regulate thyroid hormone levels.
Sources
- "Robbins Basic Pathology" Elsevier (2017)
- "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
- "Williams Textbook of Endocrinology" Elsevier (2019)
- "Ultrasound-Guided Fine-Needle Aspiration of the Thyroid Assessed by Ultrafast Papanicolaou Stain: Data from 1135 Biopsies with a Two- to Six-Year Follow-Up" Thyroid (2001)
- "Anaplastic Thyroid Cancer with Uncommon Long-term Survival" Journal of the Chinese Medical Association (2006)
- "Diagnosis and Management of Anaplastic Thyroid Cancer" Endocrinology and Metabolism Clinics of North America (2019)
- "Thyroid cancer" The Lancet (2016)
- "Multiple Endocrine Neoplasia" Surgical Oncology Clinics of North America (2015)
Copyright © 2023 Elsevier, except certain content provided by third parties
Cookies are used by this site.
USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). COMLEX-USA® is a registered trademark of The National Board of Osteopathic Medical Examiners, Inc. NCLEX-RN® is a registered trademark of the National Council of State Boards of Nursing, Inc. Test names and other trademarks are the property of the respective trademark holders. None of the trademark holders are endorsed by nor affiliated with Osmosis or this website.
