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Neoplasms of thyroid gland

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Neoplasms of thyroid gland

  1. 1. Mohit kadyan Roll no:26
  2. 2.  Papillary carcinoma (>85% os cases)  Follicular carcinoma (5 to 15% of cases)  Medullary carcinomas (5% of cases)  Anaplastic carcinomas(<5%) of cases)
  3. 3.  Most thyroid carcinomas (except medullary carcinomas) are derived from the thyroid follicular epithelium and are well differentiated lesions.  Medullary carcinomas are derived from parafollicular cells or “ C” cells.
  4. 4.  Commonest form of thyroid carcinoma  Can occur at any age but more often seen in 25 to 50 yrs of age  Commonest form associated with radiation exposure  Metastasis via lymphatics  Excellent prognosis with 10yr survival rate in 95% patients
  5. 5. Solitary or multifocal lesions  It can be soft, cystic, hard, firm.  Well circumscribed & encapsulated.  Cut surface reveals papillae 
  6. 6. The nuclei appear optically clear, giving rise to “ ground glass appearance” It shows cystic spaces , papillary projections with psammoma bodies Malignant cells shows invaginations of cytoplasm in nuclei “ Orphan annie eye” (pseudo-inclusions)
  7. 7.  Common in women (3:1) & present at older age than papillary carcinoma.  Peak incidence in 40 t0 60 yrs of age.  More incidence in areas with dietary iodine deficiency  Metastasise through blood to lungs , bone &liver. Prognosis is poorer than papillary Ca.
  8. 8. Single nodules, may be well circumscribed or infiltrative  Gray to tan on cut section and translucent due to colloid filled follicles  Uniform cells form small follicles containing colloid.  Sometimes differentiation is less. Nests and sheets of cells & no colloid. 
  9. 9.  Is a varient of follicular carcinoma of thyroid which contains abundant oxyphill cells
  10. 10.  Neuroendocrine neoplasm derived from parafollicular cells ,”C” cells.  Secrete calcitonin –helpful in diagnosis & follow-up.  They are aggressive and metastasise more frequently.
  11. 11. Solitary nodules Large lesions contain areas of hemorrhage and necrosis  Tumor tissue is firm, pale, gray to tan and infiltrative.   Composed of polygonal to spindle shaped cells, which form nests , trabaculae and even follicles.  Acellular amyloid deposits are present. 
  12. 12.  One of the most aggressive malignancies  Found in elderly , rare , less than <5%  Metastasis is common, through lymphatics &blood  Death is usually from rapid from aggressive local growth  Mortality is 100%
  13. 13.  Large solid tumour with necrosis & hemorrhage that invades surrounding structures
  14. 14.     Composed of highly anaplastic cells , includes Pleomorphic giant cells Spindle cells Mixed spindle and giant cells
  15. 15.  Solitary nodules are more likely to be neoplastic than multiple nodules.  Nodules in younger patients are more likely to be neoplastic than those in elder.  Nodules in males are more likely to be neoplastic than are those in females.
  16. 16.  THANKS …

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