Professional Documents
Culture Documents
2 Bi-lobed gland over second and third
tracheal ring
2 piramidal lobe : 40 50 %
2 Weight : 20 30 gr
2 Epithelium lined follicle
2 Colloid : glycoprotein ( thyroglobulin )
2 Vascular stroma
2 True connective tissue capsule
K
K
2 Concentrate iodine
2 20 30 % is store in thyroid
2 mall percentage in hormone and nonthyroid
tissue
2 All tyrosine compounds are bound to
thyroglubulin and store in thyroid follicles as
colloid
2 The unbound thyroid hormone is responsible
for influencing metabolism .
|
2 M=
2 Preceded by an upper respiratory tract
infection
2 taph. The most common organism
2 Painful enlargement of the gland
2 ever
2 Abscess formation
2 Common
2 Affecting 2 population
2 95 % in female Autoimmune etiology with
strong genetic predisposition
2 Diffusely enlarge with nodularity firm
2 Disrupted follicle with lymphocyte and
plasma cell infiltration and variable fibrosis
2 Residual hypothyroidism
2 ncommon
2 M
2 Older patient
2 May be mediastinal & retroperitoneal fibrosis
2 ixed rock-hard thyroid enlargement
2 Gland replaced with fibrosisAirway obstruction and
dysphagia
2 Palliative surgery to relieve obstruction
A
2 T3 , T4 , T3R
2 Thionamide , sympathetic blocker , iodine
2 Radioactive iodine
2 Compensatory response
2 Common in female econdary to dietry
deficiency
2 ymptom and sign of pressure
#$%
|
2 Thyroid suppression
2 urgery:
cosmetic deformity
pressure symptom refractory to suppression
ear of malignancy
Development of toxicity
&
@
2 Encapsulated tumor
2 Glandular epithelium with intratumoral
degenerative changes ( hemorrhage ,
fibrosis , calcification )
2 Rare thyrotoxicosis
2 Type : follicular,colloid , embryonal, fetal ,
Aurthle ???
'() '*%
2 Occult ; <1.5 cm
2 Kntrathyroid ( 70% )
2 Extrathyroid : infiltrate larynx , trachea , strap
muscle , great vessel
2 Purely papillary
2 ome may have area of follicular
2 Anaplastic transformation is rar
2 Venous invasion in 10%
K
2 Advance age
2 Male gender
2 extrathyroid extension
2 Distant metastasis
2 Dedifferentiation
2 Vascular invasion
2 Atypical variants ( tall cell, columnar ,
sclerosing ) may have negative prognostic
significance
#*%
2 Vascular invasion
2 Metastasis to bone brain and liver
2 Anaplastic transformation is more common
2 Overtly invasive : infiltrate surrounding
structure ( MR 20-50%)
2 Minimally invasive : microscopically has
capsular invasion (MR 5%)
2 Advanced age
2 Male gender extrathyroid extension
2 Distant metastasis
2 Vascular invasion
2 anaplastic transformation trabecular growth
pattern
A
*%
2 Minimally invasive
A
2 10 20 % familial
2 poradic : in 5th decade
2 Multicentric ,lateral upper 23 of gland
2 Encapsulated , diffuse infiltrative
2 50% nodal metastasis
2 15-25% distant metastasis
$
Kn addition :
2 Mucosal neuromas
2 GK ganglioneuroma
2 Musculoskeletal abnormality
2 ME type 2B
2 odal & distant metastasis
2 Extrathyroid extension
2 mall cell tumor pleomorphism
2 Poor calcitonin staining
2 Aigh CEA
#*%
2 Rare tumor
2 Arise in well-differentiated tumor
2 Older women
2 Advance stage early infiltration of
surrounding structure
2 mall cell , giant cell
2 Extremely poor prognosis
#+*%
2 arcoma
2 Mucoepidermoid carcinoma
2 CC
2 Kidney , colon , melanoma are the most
common distant site
|
2 Patchy calcification :
Benign thyroid disease
Well differentiated carcinoma
Medullary carcinoma
-X
2 Retrosternal extension
2 Tracheal deviation
2 Mediastinal nodal involvement
2 Pulmonary metastasis
-X
2 Low cost
2 Ready available
2 hort half life
2 Optimal imaging
2 Only trapped , not organified
X K
2 Detecting :
lymph node metastasis
retrosrernal extension
recurrent disease functioning
nodule within suppressed gland
A
X
A )
+
2 Extrathyroidal extension
2 Retrosternal involvement
2 Metastatic disease
2 nnecessary in the evaluation of a routine
thyroid mass
,
2 Bone scan
2 CT scan of abdomen and chest
2 Octreotide study
@
2 T3
2 T4
2 TA
2 Thyroid Ab for Aashimoto thyroiditis
2 erum thyroglobulin
2 erum calcitonin in medullary carcinoma
especially if there is a family history
|
#(
/
2 Metastasis : 50 63 %
2 Prophylactic paratracheal , superior
mediastinal and lateral neck dissection
2 Or : positive node in mediastinum and lateral
neck dissection is performed
=