On microscopy, thyroid cancer can be papillary, follicular, medullary, or anaplastic.
Risk factors include:
Non-Hodgkin’s lymphoma can occur in Hashimoto’s thyroiditis.
Anaplastic carcinoma has a poor prognosis.
Common presentations include:
Evaluation typically starts with ultrasound. Ultrasound findings that suggest malignancy include:
Ultrasound is followed by biopsy.
An iodine scan may show a cold or hot nodule.
Serum thyroglobulin is a tumor marker for thyroid cancers.
Treatment is with thyroidectomy plus RAI (radioiodine ablation) and TSH suppression.
Medullary carcinoma is always treated with thyroidectomy. Calcitonin can be used as a tumor marker.
| Type | Features |
| Papillary | RET and BRAF mutations; multiple foci; shows papillary projections, Psammoma bodies, Orphan Annie nuclei |
| Follicular | Abnormal follicles, capsular and vascular invasion |
| Medullary | Origin from parafollicular C cells, amyloid deposits, calcitonin positive; associated with MEN 2A and B; RET mutations |
| Anaplastic | P53 and BRAF mutations; poorly differentiated, giant cells |
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