CLASSIFICATION OF THYROID TUMORS

THYROID TUMORS

BENIGN

MALIGNANT

PRIMARY

SECONDARY

DIFFERNTIATED

UNDIFFERENTIATED

PARAFOLLICULAR

LYMPHOID

FOLLICULAR

ANAPLASTIC

MEDULLARY

LYMPHOMA

PAPILLARY

THYROID TUMORS
BENIGN
FOLLICULAR ADENOMA PRIMARY DIFFERENTIATED - FOLLICULAR - PAPILLARY UNDIFFERENTIATED - ANAPLASTIC PARAFOLLICULAR - MEDULLARY LYMPHOID CELL - LYMPHOMA SECONDARY METASTASIS

MALIGNANT

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

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.

PAPILLARY CARCINOMA

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.

FOLLICULAR CARCINOMA

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.

MEDULLARY CARCINOMA

ANAPLASTIC CARCINOMA - It comprises of <5% 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.

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

PAPILLARY

FOLLICULAR ANAPLASTIC

MEDULLARY

AETIOLOGY

Irradiation

Endemic goitre 17%

Unknown

Sporadic or familiar 6%

INCIDENCE

60%

13%

AGE

20-40yrs

30-50yrs

>50yrs

Middle age

DIAGNOSIS

Thyroid swelling with lymph nodes

Swelling,meta Swelling,local Difficult to stasis invasion diagnose clinically

MICROSCOPY

Orphan annie- Angio & eyed capsular nuclei,psommo invasion ma bodies

Lymphatic blood

Poorly differentiated cells

Local infiltration

Amyloid stroma like carcinoid

Lymphatic,b lood

SPREAD

INVESTIGATIO FNAC N

Frozen section

FNAC,biopsy FNAC,calcit onin

TREATMENT OF PRIMARY

Near total thyroidectomy

Functional block dissection

Near total thyriodecto my

Radioiodine I131 or external RT

Isthmusectom Total y,external RT thyroidecto my

Palliativa external radiotherapy RBD

TREATMENT OF METASTASIS

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