Thyroid Nodule Assessment
- Thyroid-Stimulating Hormone (TSH)
- Ultrasound
- Fine Needle Aspiration
- Most Accurate Test
- Radioactive Iodine Uptake (RAIU)
- Hot Nodules Rarely Malignant
- Free T3 and T4
- Repeat Ultrasound 6 -18 Months
Papillary Thyroid Carcinoma
- Most Common Thyroid Cancer
- Excellent Prognosis
- Lymphatic Spread
- Orphan Annie Nuclei
- Empty Nuclei with Central Clearing
- Psammoma Bodies
- Head and Neck Radiation
- RET and BRAF Mutations
- Gardner Syndrome
- Cowden Syndrome
Follicular Thyroid Carcinoma
- Most Common to Present as Solitary Cold Nodule
- Hematogenous Spread
- Good Prognosis
- Uniform Follicles
- May Invade Capsule
- Head and Neck Radiation
Medullary Thyroid Carcinoma
- Sporadic and Familial Types
- Arises from Parafollicular C cells
- Produces Calcitonin
- Hypocalcemia
- May Produce ACTH
- Sheets of Cells With Amyloid Deposition
- Increased Calcitonin with Pentagastrin Infusion
- MEN 2A and 2B
Anaplastic Thyroid Cancer
- Rapidly Progressive
- Poor Prognosis
- Hoarseness
- Invades Local Structures
- Mixed Morphology
- Multinodular Goiter
- Older Age
- History of Thyroid Disease