CLASSIFICATION OF THYROID TUMORS

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CLASSIFICATION OF THYROID TUMORS

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(No Transcript)
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• THYROID TUMORS
• BENIGN
  MALIGNANT
• FOLLICULAR ADENOMA
  
• 
  PRIMARY SECONDARY
• 
  DIFFERENTIATED METASTASIS
• 
  - FOLLICULAR
• 
  - PAPILLARY
• 
  UNDIFFERENTIATED
• 
  - ANAPLASTIC
• 
  PARAFOLLICULAR
• 
  - MEDULLARY
• 
  LYMPHOID CELL
• 
  - LYMPHOMA

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• FOLLICULAR ADENOMA
• - Presents as a solitary nodule
• - Seen approx in 1 population
• - It is characterised by 4 features
• - Solitary nodule
• - Complete encapsulation
• - Clearly distinct architecture
• - Compression of the thyroid
  parenchyma

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• PAPILLARY CARCINOMA
• - It is a most common type of thyroid carcinoma
  
• - Comprises of 70-80
• - Slow growing malignant tumor
• - It presents as a asymptomatic solidary nodule
• - Involvement of regional lymph nodes common.

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PAPILLARY CARCINOMA
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• FOLLICULAR CARCINOMA
• - It comprises of 10-12
• - Common in females
• - It can occur denovo or in a pre-existing multi
  nodular goitre.
• - It presents either as a solitary nodule or
  irregular firm nodular thyroid enlargement.
• - Blood borne metastasis is more common.

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FOLLICULAR CARCINOMA
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• MEDULLARY CARCINOMA
• - It is less frequent (5)
• - It arises from the parafollicular cells
• - There are 3 distinctive features
• - Familial occurance
• - Secretion of calcitonin
• - Amyloid stroma
• - Regional lymph node metastasis may occur.

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MEDULLARY CARCINOMA
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• ANAPLASTIC CARCINOMA
• - It comprises of lt5 of all thyroid tumors
• - This occurs commonlyn in 7th 8th decades
• - The tumor is wildely aggressive rapidly
  growing
• - Local infiltration is early feature of this
  tumor.

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• MALIGNANT LYMPHOMA
• - It is NHL type.
• - Occurs in pre-existing Hashimotos
  Thyroiditis.
• - Chemotherapy is the main treatment.

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PAPILLARY FOLLICULAR ANAPLASTIC MEDULLARY
AETIOLOGY Irradiation Endemic goitre Unknown Sporadic or familiar
INCIDENCE 60 17 13 6
AGE 20-40yrs 30-50yrs gt50yrs Middle age
DIAGNOSIS Thyroid swelling with lymph nodes Swelling,metastasis Swelling,local invasion Difficult to diagnose clinically
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MICROSCOPY Orphan annie-eyed nuclei,psommoma bodies Angio capsular invasion Poorly differentiated cells Amyloid stroma like carcinoid
SPREAD Lymphatic blood Local infiltration Lymphatic,blood
INVESTIGATION FNAC Frozen section FNAC,biopsy FNAC,calcitonin
TREATMENT OF PRIMARY Near total thyroidectomy Near total thyriodectomy Isthmusectomy,external RT Total thyroidectomy
TREATMENT OF METASTASIS Functional block dissection Radio-iodine I131 or external RT Palliativa external radiotherapy RBD
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