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Mohit kadyan
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

Papillary carcinoma (>85% os cases)



Follicular carcinoma (5 to 15% of cases)



Medullary carcinomas (5% of cases)



Anaplastic carcinomas(<5%) of cases)


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.


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
Solitary or multifocal
lesions
 It can be soft, cystic,
hard, firm.
 Well circumscribed &
encapsulated.
 Cut surface reveals
papillae

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)


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.
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.



Is a varient of follicular carcinoma of thyroid
which contains abundant oxyphill cells


Neuroendocrine neoplasm derived from
parafollicular cells ,”C” cells.



Secrete calcitonin –helpful in diagnosis &
follow-up.



They are aggressive and metastasise more
frequently.
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.



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%


Large solid tumour
with necrosis &
hemorrhage that
invades surrounding
structures





Composed of highly anaplastic cells , includes
Pleomorphic giant cells
Spindle cells
Mixed spindle and giant cells


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.


THANKS …

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Neoplasms of thyroid gland

  • 2.  Papillary carcinoma (>85% os cases)  Follicular carcinoma (5 to 15% of cases)  Medullary carcinomas (5% of cases)  Anaplastic carcinomas(<5%) of cases)
  • 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.  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. Solitary or multifocal lesions  It can be soft, cystic, hard, firm.  Well circumscribed & encapsulated.  Cut surface reveals papillae 
  • 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.
  • 8.  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.
  • 9. 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. 
  • 10.  Is a varient of follicular carcinoma of thyroid which contains abundant oxyphill cells
  • 11.  Neuroendocrine neoplasm derived from parafollicular cells ,”C” cells.  Secrete calcitonin –helpful in diagnosis & follow-up.  They are aggressive and metastasise more frequently.
  • 12. 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. 
  • 13.  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%
  • 14.  Large solid tumour with necrosis & hemorrhage that invades surrounding structures
  • 15.     Composed of highly anaplastic cells , includes Pleomorphic giant cells Spindle cells Mixed spindle and giant cells
  • 16.  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.