Medullary thyroid cancer differential diagnosis: Difference between revisions

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__NOTOC__
__NOTOC__
{{Medullary thyroid cancer}}
{{Medullary thyroid cancer}}
{{CMG}}; {{AE}} {{Ammu}}
{{CMG}}; {{AE}} {{Sahar}} {{Ammu}}
==Overview==
==Overview==
Medullary thyroid cancer must be differentiated from [[anaplastic thyroid carcinoma]], [[papillary thyroid carcinoma]], [[paraganglioma]], [[carcinoid tumor]], and [[Hurthle cell carcinoma]].
Medullary thyroid cancer must be differentiated from [[anaplastic thyroid carcinoma]], [[papillary thyroid carcinoma]], [[paraganglioma]], [[carcinoid tumor]], and [[Hurthle cell carcinoma]].
Line 11: Line 11:
:*[[Paraganglioma]]  
:*[[Paraganglioma]]  
:*[[Carcinoid]]
:*[[Carcinoid]]
:*Metastatic Melanoma<ref>Thyroid Cancer Cancer.gov
:*Metastatic Melanoma
(2015). http://www.cancer.gov/types/thyroid/hp/thyroid-treatment-pdq#link/stoc_h2_2- Accessed on October, 29 2015</ref>
 
{| border="3"
|+
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Disease Name}}
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Age of Onset}}
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Gender Preponderance}}
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Signs/Symptoms}}
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Imaging Feature(s)}}
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Macroscopic Feature(s)}}
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Microscopic Feature(s)}}
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Laboratory Findings(s)}}
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Other Feature(s)}}
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Microscopic Appearance}}
|-
! style="padding: 5px 5px; background: #DCDCDC;" align="left" |Medullary Thyroid Cancer<ref name="pmid6690009">{{cite journal |vauthors=Busnardo B, Girelli ME, Simioni N, Nacamulli D, Busetto E |title=Nonparallel patterns of calcitonin and carcinoembryonic antigen levels in the follow-up of medullary thyroid carcinoma |journal=Cancer |volume=53 |issue=2 |pages=278–85 |date=January 1984 |pmid=6690009 |doi=10.1002/1097-0142(19840115)53:2<278::aid-cncr2820530216>3.0.co;2-z |url=}}</ref><ref name="pmid10699905">{{cite journal |vauthors=Kebebew E, Ituarte PH, Siperstein AE, Duh QY, Clark OH |title=Medullary thyroid carcinoma: clinical characteristics, treatment, prognostic factors, and a comparison of staging systems |journal=Cancer |volume=88 |issue=5 |pages=1139–48 |date=March 2000 |pmid=10699905 |doi=10.1002/(sici)1097-0142(20000301)88:5<1139::aid-cncr26>3.0.co;2-z |url=}}</ref><ref name="HofstraLandsvater1994">{{cite journal|last1=Hofstra|first1=Robert M. W.|last2=Landsvater|first2=Rudy M.|last3=Ceccherini|first3=Isabella|last4=Stulp|first4=Rein P.|last5=Stelwagen|first5=Tineke|last6=Luo|first6=Yin|last7=Pasini|first7=Barbara|last8=Hoppener|first8=Jo W. M.|last9=van Amstel|first9=Hans Kristian Ploos|last10=Romeo|first10=Giovanni|last11=Lips|first11=Cornells J. M.|last12=Buys|first12=Charles H. C. M.|title=A mutation in the RET proto-oncogene associated with multiple endocrine neoplasia type 2B and sporadic medullary thyroid carcinoma|journal=Nature|volume=367|issue=6461|year=1994|pages=375–376|issn=0028-0836|doi=10.1038/367375a0}}</ref><ref name="pmid20001718">{{cite journal |vauthors=Sipos JA |title=Advances in ultrasound for the diagnosis and management of thyroid cancer |journal=Thyroid |volume=19 |issue=12 |pages=1363–72 |date=December 2009 |pmid=20001718 |doi=10.1089/thy.2009.1608 |url=}}</ref>
 
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Incidence]] increases with age
* More common in the 3rd to 4th decades of life
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Both genders are affected equally
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Solitary]] [[thyroid nodule]]
* Mostly affects upper [[Lobe (anatomy)|lobe]] of [[thyroid gland]]
* Possible [[systemic]] [[symptoms]] due to [[Hormone|hormonal]] [[secretion]] by the [[tumor]]
*[[Cervical]] [[lymphadenopathy]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*On [[ultrasound]]:
**[[Solitary]] hypoechoic [[nodule]] with or without [[calcification]]
*[[Imaging]] features are not characteristic of this [[cancer]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Single non-encapsulated mass
* Gray-tan color
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Sheets of [[cells]] in an [[amyloid]] [[stroma]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Secretion|Secretes]] [[calcitonin]]
*Normal [[thyroid function test|thyroid function tests]]
*[[Carcinoembryonic antigen]] ([[CEA]]) may be used as a [[tumor marker]]
*Rarely negative for [[calcitonin]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Can be part of [[MEN syndromes|MEN 2A]] and [[Multiple endocrine neoplasia type 2|2B syndrome]]
* Can be associated with [[RET gene|RET]] [[mutation]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[File:Thyroid MedullaryCarcinoma SpindleCell LP PA.JPG|thumb|none|200px|Source:Wikimedia common ]]
|-
! style="padding: 5px 5px; background: #DCDCDC; " align="left" |Papillary Thyroid Cancer<ref name="FaginMitsiades2008">{{cite journal|last1=Fagin|first1=James A.|last2=Mitsiades|first2=Nicholas|title=Molecular pathology of thyroid cancer: diagnostic and clinical implications|journal=Best Practice & Research Clinical Endocrinology & Metabolism|volume=22|issue=6|year=2008|pages=955–969|issn=1521690X|doi=10.1016/j.beem.2008.09.017}}</ref><ref name="Schlumberger1998">{{cite journal|last1=Schlumberger|first1=Martin Jean|title=Papillary and Follicular Thyroid Carcinoma|journal=New England Journal of Medicine|volume=338|issue=5|year=1998|pages=297–306|issn=0028-4793|doi=10.1056/NEJM199801293380506}}</ref><ref name="pmid20001718">{{cite journal |vauthors=Sipos JA |title=Advances in ultrasound for the diagnosis and management of thyroid cancer |journal=Thyroid |volume=19 |issue=12 |pages=1363–72 |date=December 2009 |pmid=20001718 |doi=10.1089/thy.2009.1608 |url=}}</ref>
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* More common in the middle aged (30 - 50 years of age)
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* More commonly affects women
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Asymptomatic]] [[thyroid]] [[mass]] or [[nodule]]
*Compressive [[symptoms]], such as:
*[[Dysphagia|Difficulty swallowing]]/[[Dyspnea|breathing]]
*Persistent [[cough]]
*[[Stridor]]
*[[Vocal cord|Vocal chord]] [[paralysis]]
*Rapid enlarging [[mass]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* On [[ultrasound]]
** [[Solitary]] [[mass]] with an irregular outline
** Located in the sub-capsular region
** High [[vascularity]]
 
*[[Imaging]] features are not characteristic of this [[cancer]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Solitary]] hypoechogenic [[nodule]] with [[Lobule|lobulated]] margin which may extend into adjacent [[tissues]]
*[[Calcification]] may be present or not
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Empty-appearing [[nuclei]] with central clearing (Orphan Annie eye)
*[[Psammoma body|Psammoma bodies]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Thyroid function test|Thyroid function tests]] can be normal
*Serum [[thyroglobulin]] can be used as a [[tumor marker]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* History of [[radiation]] to the [[head]] and [[neck]]
*[[BRAF]] and/or [[RET gene|RET]] [[mutation]] may be present
*The most common type of thyroid cancer
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Image:Thyroid papillary carcinoma histopathology (3).jpg|thumb|none|200px|Source:Wikimedia commons ]]
|-
! style="padding: 5px 5px; background: #DCDCDC; " align="left" |Follicular Thyroid Cancer<ref name="Schlumberger1998">{{cite journal|last1=Schlumberger|first1=Martin Jean|title=Papillary and Follicular Thyroid Carcinoma|journal=New England Journal of Medicine|volume=338|issue=5|year=1998|pages=297–306|issn=0028-4793|doi=10.1056/NEJM199801293380506}}</ref><ref name="pmid20001718">{{cite journal |vauthors=Sipos JA |title=Advances in ultrasound for the diagnosis and management of thyroid cancer |journal=Thyroid |volume=19 |issue=12 |pages=1363–72 |date=December 2009 |pmid=20001718 |doi=10.1089/thy.2009.1608 |url=}}</ref><ref name="pmid2019455">{{cite journal |vauthors=Pettersson B, Adami HO, Wilander E, Coleman MP |title=Trends in thyroid cancer incidence in Sweden, 1958-1981, by histopathologic type |journal=Int. J. Cancer |volume=48 |issue=1 |pages=28–33 |date=April 1991 |pmid=2019455 |doi=10.1002/ijc.2910480106 |url=}}</ref>
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Peak [[incidence]] at 40 - 60 years of age
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* More commonly affects women
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Asymptomatic]] [[thyroid]] [[mass]] or [[nodule]]
*Compressive [[symptoms]], such as:
*[[Difficulty swallowing]]/[[Dyspnea|breathing]]
*Persistent [[cough]]
*[[Stridor]]
*[[Vocal cord|Vocal chord]] [[paralysis]]
*Rapid enlarging [[mass]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* On [[ultrasound]]:
**Solid hypoechoic [[nodule]] with a peripheral halo indicating [[fibrous capsule]]
**Irregular margin
*[[Imaging]] features are not characteristic of this [[cancer]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Single encapsulated [[nodule]]
* Thick and irregular [[capsule]]
* Can be [[cystic]] or [[hemorrhage|hemorrhagic]] in appearance
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Invades [[thyroid]] [[capsule]] and [[vasculature]]
* Uniform [[Follicle|follicles]] <br />
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Thyroid function test|Thyroid function tests]] can be normal
* Serum [[thyroglobulin]] can be used as a [[tumor marker]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[RASA3|RAS]] [[mutation]] may be present
*[[PAX8]]-[[PPAR|PPARγ]]  [[Translocation|translocations]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Image:Metastatic follicular thyroid carcinoma - Case 264.jpg|thumb|none|200px|Source:Wikimedia common ]]
|-
 
! style="padding: 5px 5px; background: #DCDCDC;" align="left" |Anaplastic Thyroid Cancer<ref name="pmid21772843">{{cite journal |vauthors=Nagaiah G, Hossain A, Mooney CJ, Parmentier J, Remick SC |title=Anaplastic thyroid cancer: a review of epidemiology, pathogenesis, and treatment |journal=J Oncol |volume=2011 |issue= |pages=542358 |date=2011 |pmid=21772843 |pmc=3136148 |doi=10.1155/2011/542358 |url=}}</ref><ref name="pmid2794956">{{cite journal |vauthors=Chang TC, Liaw KY, Kuo SH, Chang CC, Chen FW |title=Anaplastic thyroid carcinoma: review of 24 cases, with emphasis on cytodiagnosis and leukocytosis |journal=Taiwan Yi Xue Hui Za Zhi |volume=88 |issue=6 |pages=551–6 |date=June 1989 |pmid=2794956 |doi= |url=}}</ref><ref name="pmid1695118">{{cite journal |vauthors=Venkatesh YS, Ordonez NG, Schultz PN, Hickey RC, Goepfert H, Samaan NA |title=Anaplastic carcinoma of the thyroid. A clinicopathologic study of 121 cases |journal=Cancer |volume=66 |issue=2 |pages=321–30 |date=July 1990 |pmid=1695118 |doi=10.1002/1097-0142(19900715)66:2<321::aid-cncr2820660221>3.0.co;2-a |url=}}</ref>
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* More common among older individuals
*[[Mean]] age at [[diagnosis]] is 65 years
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* More commonly affects women
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Rapidly enlarging [[thyroid]] [[mass]]
* May manifest with compressive [[symptoms]]
*Can present with [[signs]]/[[symptoms]] of [[metastasis]]
*Constitutional [[symptoms]] may be present
*Hard [[Nodule (medicine)|nodular]] [[goiter]] without [[tenderness]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* On [[ultrasound]]:
** Solid hypoechoic [[nodule]] with a peripheral halo indicating [[fibrous capsule]]
 
** Irregular margin
*[[Imaging]] features are not characteristic of this [[cancer]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Solid [[tumor]] with areas of [[necrosis]] and [[hemorrhage]]
*[[Infiltration (medical)|Infiltrative]] pattern
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Undifferentiated, devastatingly aggressive variant of [[Papillary thyroid cancer|papillary]]/[[follicular thyroid cancer]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Normal [[thyroid function test|thyroid function tests]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Poor [[prognosis]]
* May be associated with [[TP53]] [[mutation]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[File:Anaplastic thyroid carcinoma low mag.jpg|thumb|none|200px|Source:Wikimedia common ]]
|-
! style="padding: 5px 5px; background: #DCDCDC;" align="left" |Follicular Adenoma<ref name="MathurOlson2014">{{cite journal|last1=Mathur|first1=Aarti|last2=Olson|first2=Matthew T.|last3=Zeiger|first3=Martha A.|title=Follicular Lesions of the Thyroid|journal=Surgical Clinics of North America|volume=94|issue=3|year=2014|pages=499–513|issn=00396109|doi=10.1016/j.suc.2014.02.005}}</ref>
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* More commonly affects individuals older than 50 years of age
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* More commonly affects women
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Asymptomatic]] or [[symptoms]] of [[hyperthyroidism]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Solitary [[nodule]] which may show echogenicity or not
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Solitary, spherical, and encapsulated [[lesion]]
* Well demarcated from the surrounding [[parenchyma]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Uniform  [[Follicle|follicles]]
* Absence of capsular or [[vascular]] invasion
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Functional [[adenoma]]:
** Elevated T3, T4
** Decreased TSH
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* May be considered functional or hot
* May be considered non-functional or cold
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[File:Follicular adenoma -- intermed mag.jpg|thumb|none|200px|Source:Wikimedia common ]]
|-
! style="padding: 5px 5px; background: #DCDCDC;" align="left" |Multinodular Goiter<ref name="pmid8197088">{{cite journal |vauthors=Bronshteĭn ME, Makarov AD, Artemova AM, Bazarova EN, Kozlov GI |title=[Morphology of the thyroid tissue in multinodular euthyroid goiter] |language=Russian |journal=Probl Endokrinol (Mosk) |volume=40 |issue=2 |pages=36–9 |date=1994 |pmid=8197088 |doi= |url=}}</ref>
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Commonly affects individuals older than 60 years of age
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* More commonly affects women
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Thyroid]] enlargement
*[[Signs]]/[[symptoms]] of [[Hypothyroidism|hypo]]/[[hyperthyroidism]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Multiple [[nodules]] with different echogenicity
*[[Calcification]] may be present
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Multiple [[Thyroid nodule|thyroid nodules]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Variable sized [[Follicle|follicles]]
* Some may show [[papillary]] [[Projection areas|projections]] without [[nuclear]] characteristics of [[papillary thyroid cancer]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Classification|Classified]] as toxic and non-toxic
**'''Toxic:''' [[Hyperthyroidism]]
**'''Non-toxic:''' Normal [[thyroid function test|thyroid function tests]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Benign]] [[condition]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[File:ThyroidnodularSatturwar08.jpg|thumb|none|200px|Source:pathology outline, case courtesy of Dr. Swati Satturwar]]
|-
! style="padding: 5px 5px; background: #DCDCDC; " align="left" |Thyroid Lymphoma<ref name="pmid8838117">{{cite journal |vauthors=Pedersen RK, Pedersen NT |title=Primary non-Hodgkin's lymphoma of the thyroid gland: a population based study |journal=Histopathology |volume=28 |issue=1 |pages=25–32 |date=January 1996 |pmid=8838117 |doi= |url=}}</ref>
<ref name="pmid3141260">{{cite journal |vauthors=Hyjek E, Isaacson PG |title=Primary B cell lymphoma of the thyroid and its relationship to Hashimoto's thyroiditis |journal=Hum. Pathol. |volume=19 |issue=11 |pages=1315–26 |date=November 1988 |pmid=3141260 |doi=10.1016/s0046-8177(88)80287-9 |url=}}</ref><ref name="pmid3759532">{{cite journal |vauthors=Tupchong L, Hughes F, Harmer CL |title=Primary lymphoma of the thyroid: clinical features, prognostic factors, and results of treatment |journal=Int. J. Radiat. Oncol. Biol. Phys. |volume=12 |issue=10 |pages=1813–21 |date=October 1986 |pmid=3759532 |doi=10.1016/0360-3016(86)90324-x |url=}}</ref><ref name="pmid17042683">{{cite journal |vauthors=Ota H, Ito Y, Matsuzuka F, Kuma S, Fukata S, Morita S, Kobayashi K, Nakamura Y, Kakudo K, Amino N, Miyauchi A |title=Usefulness of ultrasonography for diagnosis of malignant lymphoma of the thyroid |journal=Thyroid |volume=16 |issue=10 |pages=983–7 |date=October 2006 |pmid=17042683 |doi=10.1089/thy.2006.16.983 |url=}}</ref>
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Affects [[Adult|adults]] or elderly
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* More common among women
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Rapidly enlarging mass/[[nodule]] of [[thyroid]]
* Compressive [[symptoms]] may be present
* [[B symptoms|Constitiutional symptoms]] can be present in 10%
*[[Physical examination|P/E]]:Firm, hard [[thyroid]]
* Fixed to the nearby structures
* Immobile even during swallowing
* [[Cervical]] or [[supraclavicular]] [[lymphadenopathy]] may be present
 
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* On [[ultrasound]]:
**Hypoechogenic appearance
**Difficult to distinguish from [[Chronic (medical)|chronic]] [[thyroiditis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Thyroid nodule]]/mass
*Fixed to adjacent [[tissue]]
*Firm texture
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* It is of [[B cell]] lineage in the majority of cases
* Dffuse, large [[B-cell lymphoma|B-cell lymphomas]] is the most common subtype
* [[Marginal zone lymphoma]] is the second most common type
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* No specific test
* Some [[Patient|patients]] may have [[hypothyroidism]]
*[[Patient|Patients]] can also have [[antibody|antibodies]] against [[thyroid peroxidase]] or [[thyroglobulin]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Preexisting [[Chronic (medical)|chronic]] [[Hashimoto's thyroiditis|autoimmune (Hashimoto's) thyroiditis]] is a known [[risk factor]] for this [[condition]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[File:Thyroid lymphoma large cell type fine needle aspiration biop.jpeg|thumb|none|200px|Source:pathology outline, case courtesy of Dr. Mark R. Wick]]
|}
==Reference==
==Reference==
{{Reflist|2}}
{{Reflist|2}}

Latest revision as of 18:16, 19 August 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2] Ammu Susheela, M.D. [3]

Overview

Medullary thyroid cancer must be differentiated from anaplastic thyroid carcinoma, papillary thyroid carcinoma, paraganglioma, carcinoid tumor, and Hurthle cell carcinoma.

Differentiating Medullary thyroid cancer from other Diseases

  • Medullary thyroid cancer must be differentiated from the following:
Disease Name Age of Onset Gender Preponderance Signs/Symptoms Imaging Feature(s) Macroscopic Feature(s) Microscopic Feature(s) Laboratory Findings(s) Other Feature(s) Microscopic Appearance
Medullary Thyroid Cancer[1][2][3][4]
  • Incidence increases with age
  • More common in the 3rd to 4th decades of life
  • Both genders are affected equally
  • Single non-encapsulated mass
  • Gray-tan color
Source:Wikimedia common
Papillary Thyroid Cancer[5][6][4]
  • More common in the middle aged (30 - 50 years of age)
  • More commonly affects women
Source:Wikimedia commons
Follicular Thyroid Cancer[6][4][7]
  • More commonly affects women
Source:Wikimedia common
Anaplastic Thyroid Cancer[8][9][10]
  • More common among older individuals
  • Mean age at diagnosis is 65 years
  • More commonly affects women
    • Irregular margin
  • Imaging features are not characteristic of this cancer
Source:Wikimedia common
Follicular Adenoma[11]
  • More commonly affects individuals older than 50 years of age
  • More commonly affects women
  • Solitary nodule which may show echogenicity or not
  • Solitary, spherical, and encapsulated lesion
  • Well demarcated from the surrounding parenchyma
  • Functional adenoma:
    • Elevated T3, T4
    • Decreased TSH
  • May be considered functional or hot
  • May be considered non-functional or cold
Source:Wikimedia common
Multinodular Goiter[12]
  • Commonly affects individuals older than 60 years of age
  • More commonly affects women
Source:pathology outline, case courtesy of Dr. Swati Satturwar
Thyroid Lymphoma[13]

[14][15][16]

  • More common among women
Source:pathology outline, case courtesy of Dr. Mark R. Wick

Reference

  1. ↑ Busnardo B, Girelli ME, Simioni N, Nacamulli D, Busetto E (January 1984). "Nonparallel patterns of calcitonin and carcinoembryonic antigen levels in the follow-up of medullary thyroid carcinoma". Cancer. 53 (2): 278–85. doi:10.1002/1097-0142(19840115)53:2<278::aid-cncr2820530216>3.0.co;2-z. PMID 6690009.
  2. ↑ Kebebew E, Ituarte PH, Siperstein AE, Duh QY, Clark OH (March 2000). "Medullary thyroid carcinoma: clinical characteristics, treatment, prognostic factors, and a comparison of staging systems". Cancer. 88 (5): 1139–48. doi:10.1002/(sici)1097-0142(20000301)88:5<1139::aid-cncr26>3.0.co;2-z. PMID 10699905.
  3. ↑ Hofstra, Robert M. W.; Landsvater, Rudy M.; Ceccherini, Isabella; Stulp, Rein P.; Stelwagen, Tineke; Luo, Yin; Pasini, Barbara; Hoppener, Jo W. M.; van Amstel, Hans Kristian Ploos; Romeo, Giovanni; Lips, Cornells J. M.; Buys, Charles H. C. M. (1994). "A mutation in the RET proto-oncogene associated with multiple endocrine neoplasia type 2B and sporadic medullary thyroid carcinoma". Nature. 367 (6461): 375–376. doi:10.1038/367375a0. ISSN 0028-0836.
  4. ↑ 4.0 4.1 4.2 Sipos JA (December 2009). "Advances in ultrasound for the diagnosis and management of thyroid cancer". Thyroid. 19 (12): 1363–72. doi:10.1089/thy.2009.1608. PMID 20001718.
  5. ↑ Fagin, James A.; Mitsiades, Nicholas (2008). "Molecular pathology of thyroid cancer: diagnostic and clinical implications". Best Practice & Research Clinical Endocrinology & Metabolism. 22 (6): 955–969. doi:10.1016/j.beem.2008.09.017. ISSN 1521-690X.
  6. ↑ 6.0 6.1 Schlumberger, Martin Jean (1998). "Papillary and Follicular Thyroid Carcinoma". New England Journal of Medicine. 338 (5): 297–306. doi:10.1056/NEJM199801293380506. ISSN 0028-4793.
  7. ↑ Pettersson B, Adami HO, Wilander E, Coleman MP (April 1991). "Trends in thyroid cancer incidence in Sweden, 1958-1981, by histopathologic type". Int. J. Cancer. 48 (1): 28–33. doi:10.1002/ijc.2910480106. PMID 2019455.
  8. ↑ Nagaiah G, Hossain A, Mooney CJ, Parmentier J, Remick SC (2011). "Anaplastic thyroid cancer: a review of epidemiology, pathogenesis, and treatment". J Oncol. 2011: 542358. doi:10.1155/2011/542358. PMC 3136148. PMID 21772843.
  9. ↑ Chang TC, Liaw KY, Kuo SH, Chang CC, Chen FW (June 1989). "Anaplastic thyroid carcinoma: review of 24 cases, with emphasis on cytodiagnosis and leukocytosis". Taiwan Yi Xue Hui Za Zhi. 88 (6): 551–6. PMID 2794956.
  10. ↑ Venkatesh YS, Ordonez NG, Schultz PN, Hickey RC, Goepfert H, Samaan NA (July 1990). "Anaplastic carcinoma of the thyroid. A clinicopathologic study of 121 cases". Cancer. 66 (2): 321–30. doi:10.1002/1097-0142(19900715)66:2<321::aid-cncr2820660221>3.0.co;2-a. PMID 1695118.
  11. ↑ Mathur, Aarti; Olson, Matthew T.; Zeiger, Martha A. (2014). "Follicular Lesions of the Thyroid". Surgical Clinics of North America. 94 (3): 499–513. doi:10.1016/j.suc.2014.02.005. ISSN 0039-6109.
  12. ↑ Bronshteĭn ME, Makarov AD, Artemova AM, Bazarova EN, Kozlov GI (1994). "[Morphology of the thyroid tissue in multinodular euthyroid goiter]". Probl Endokrinol (Mosk) (in Russian). 40 (2): 36–9. PMID 8197088.
  13. ↑ Pedersen RK, Pedersen NT (January 1996). "Primary non-Hodgkin's lymphoma of the thyroid gland: a population based study". Histopathology. 28 (1): 25–32. PMID 8838117.
  14. ↑ Hyjek E, Isaacson PG (November 1988). "Primary B cell lymphoma of the thyroid and its relationship to Hashimoto's thyroiditis". Hum. Pathol. 19 (11): 1315–26. doi:10.1016/s0046-8177(88)80287-9. PMID 3141260.
  15. ↑ Tupchong L, Hughes F, Harmer CL (October 1986). "Primary lymphoma of the thyroid: clinical features, prognostic factors, and results of treatment". Int. J. Radiat. Oncol. Biol. Phys. 12 (10): 1813–21. doi:10.1016/0360-3016(86)90324-x. PMID 3759532.
  16. ↑ Ota H, Ito Y, Matsuzuka F, Kuma S, Fukata S, Morita S, Kobayashi K, Nakamura Y, Kakudo K, Amino N, Miyauchi A (October 2006). "Usefulness of ultrasonography for diagnosis of malignant lymphoma of the thyroid". Thyroid. 16 (10): 983–7. doi:10.1089/thy.2006.16.983. PMID 17042683.
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