In the Name of God. Thyroid Nodules. Nodular thyroid disease is a common problem Five percent are likely to be malignant Assessment for malignant potential is important. Prevalence and Incidence of Thyroid Nodules and Cancer. Prevalence Nodule % Clinical 4-7 Radiological 40
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Follicular cell origin
C cell origin
Thyroid CancerRelative Frequency
*National Cancer Database: SEER Registry
Autonomic ganglia GI tract
Clinical Features and MEN-2B
MEN2A FMTC MEN2B
532 : duplication de nucléotides
Tyrosine kinase domain
Clin Endocrinol 61:299, 2004
558 patients 765 patients 1991-1999 1979-1989
Routine thyroid function tests were normal. A thyroid ultrasound revealed the nodule to be 2.6 cm and solid. A fine needle aspiration biopsy was “indeterminate”.Thyroid NoduleCase 2
The results of this biopsy were “ follicular neoplasm.” The physician advised surgery, but the patient has insisted upon a second opinion.Thyroid NoduleCase 2 (Continued)
that moves easily with swallowing. The patient’s skin is warm and dry. There is no tremor nor other peripheral signs of hypothyroidism or hyperthyroidism.Thyroid NoduleCase 2 (Continued)
The specimen in Panel A shows typical changes of Hashimoto’s thyroiditis, including lymphoid follicles with germinal centers (G), small lymphocytes and plasma cells (P), thyroid follicles with Hürthle-cell metaplasia
(H), and minimal colloid material (C).
Her serum T4 is 6.1 mcg/dl, T3RU 26%, and TSH 28.2 mU/L.Goiter and Subclinical Hypothyroidism in a Postpartum Woman
The specimen in Panel B, obtained from a patient with painless postpartum thyroiditis, shows normal follicles with minimal Hürthle-cell metaplasia (H) and dense lymphocytic infiltration
(WG) without germinal centers.