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Thyroid Pathology

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Thyroid Cancer in Clinical Practice

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Abstract

Cancers that arise from follicular cells are classified along a morphologic spectrum into well-differentiated carcinomas at one pole and anaplastic (undifferentiated) carcinomas at the other. Well-differentiated carcinomas retain the appearance of follicular cells and can trap iodine and secrete thyroglobulin (Tg). Based on histology, they are subclassified as papillary, or follicular types. Anaplastic carcinomas are undifferentiated neoplasms of follicular cell origin that often bear little resemblance to follicular cells. C cells (parafollicular cells) can undergo malignant transformation and are called medullary cancer. Lymphomas and leukemias arise from hematolymphoid cells and sarcomas are of mesenchymal cell origin. In geographic regions of high iodine intake, about 80% of thyroid cancers are differentiated and, of these, 90% are papillary carcinomas, 5%–10% follicular carcinomas, another 5%–10% are medullary carcinomas, 2%–5% anaplastic carcinomas, and 2%–5% malignant lymphomas (Figure 4.1). Rarely, nonthyroidal cancers can metastasize to the thyroid. A close working relationship with a pathologist interested in thyroid pathology is indispensable in the management of patients, and pathology slides of patients referred for treatment from another institution should always be reviewed. Treatment and prognosis are determined in large part by the histologic type of neoplasm. For example, it is essential that adenoma be carefully distinguished from minimally invasive or widely invasive follicular carcinoma.

The algorithm illustrates the types of cancers found in the thyroid gland and their cell of origin.

With special contribution from Gerald J. Berry

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© 2007 Springer-Verlag London Limited

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(2007). Thyroid Pathology. In: Thyroid Cancer in Clinical Practice. Springer, London. https://doi.org/10.1007/978-1-84628-748-0_4

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  • DOI: https://doi.org/10.1007/978-1-84628-748-0_4

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84628-544-8

  • Online ISBN: 978-1-84628-748-0

  • eBook Packages: MedicineMedicine (R0)

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