Quiz-summary
0 of 1 questions completed
Questions:
- 1
Information
Presented by Ralph Hruban, M.D. and prepared by Matthew Karafin, M.D.
Case 2: This elderly patient developed shortness of breath.
You have already completed the quiz before. Hence you can not start it again.
Quiz is loading...
You must sign in or sign up to start the quiz.
You have to finish following quiz, to start this quiz:
Results
Time has elapsed
Categories
- Not categorized 0%
- 1
- Answered
- Review
-
Question 1 of 1
1. Question
Week 491: Case 2
This elderly patient developed shortness of breath. A segment of the trachea was resected.images/1alex/0801case2image1.jpg
images/1alex/0801case2image2.jpg
images/1alex/0801case2image3.jpgCorrect
Answer: Metastatic papillary thyroid carcinoma
Histology: The submucosa is distended by neoplastic cells. These cells occasionally form follicles around colloid. The nuclei are open, and often overlapping. An immunostain for thyroglobulin was positive as was an immunostain for Pax-8.
Discussion: This is an example of a common tumor in an uncommon location.
Papillary thyroid carcinoma represents 80% of malignant thyroid neoplasms and occurs largely in young to middle-aged adults with a 4 to 1 female to male ratio. There is a close link with radiation exposure. Fine needle aspiration is the study of choice for a thyroid nodule and has an excellent positive predictive value.
Microscopically, the diagnosis of papillary thyroid carcinoma is made using a combination of architectural and cytologic features. Variable architectural growth patterns can be seen including complex papillae and elongated follicles. Psammoma bodies and “bubble gum” colloid also support the diagnosis. Cytologic features that support the diagnosis include overlapping nuclei, optically clear nuclei, nuclear grooves and nuclear pseudoinclusions.Papillary carcinoma preferentially spreads via the lymphatics to regional lymph nodes. Intraglandular spread, including spread to the contralateral lobe is common. The prognosis is excellent with >98% 20-year survival.
Incorrect
Answer: Metastatic papillary thyroid carcinoma
Histology: The submucosa is distended by neoplastic cells. These cells occasionally form follicles around colloid. The nuclei are open, and often overlapping. An immunostain for thyroglobulin was positive as was an immunostain for Pax-8.
Discussion: This is an example of a common tumor in an uncommon location.
Papillary thyroid carcinoma represents 80% of malignant thyroid neoplasms and occurs largely in young to middle-aged adults with a 4 to 1 female to male ratio. There is a close link with radiation exposure. Fine needle aspiration is the study of choice for a thyroid nodule and has an excellent positive predictive value.
Microscopically, the diagnosis of papillary thyroid carcinoma is made using a combination of architectural and cytologic features. Variable architectural growth patterns can be seen including complex papillae and elongated follicles. Psammoma bodies and “bubble gum” colloid also support the diagnosis. Cytologic features that support the diagnosis include overlapping nuclei, optically clear nuclei, nuclear grooves and nuclear pseudoinclusions.Papillary carcinoma preferentially spreads via the lymphatics to regional lymph nodes. Intraglandular spread, including spread to the contralateral lobe is common. The prognosis is excellent with >98% 20-year survival.
