Thyroid cancer pathology

2021-01-27 12:00 AM

Occurrence rates are high, especially in young women, with good prognosis. Sometimes there is the ability to capture the iodin, but rarely the detail.

Classify

Thyroid cancer accounts for 1% of all deaths due to cancer, this is a group of diseases with very different prognosis, it is divided into:

Thyroid cell carcinomas include:

Differentiated cancer, good prognosis with correct treatment, disease easily appears when irradiated in the neck from adolescence or atomic infection.

Cancer does not differentiate very bad prognosis.

Medullary carcinomas, which develop from the C-cell of the thyroid gland.

Particularly, lymphoma or other cancer has metastasized

Differentiated thyroid cancer

Occurrence rates are high, especially in young women, with good prognosis. Sometimes there is the ability to capture the iodin, but rarely the detail.

Carcinome papillaire :

Accounting for 50% of cases, common in all ages, but common in children and young people before 40 years old, neck irradiation is a favourable condition causing papillary epithelial K, lymphatic spread, yes when the disease is initially suggested from a metastatic lymph node in the neck area.

Poor iodin imaging ("cold" region).

Cystic epithelium (follicular carcinoma):

Account for less than 25% of cases, common in the age group 40-60, metastasis by blood sugar

to bones, lungs, liver.

Radiation u can capture irregular iodin, metastasis can also capture radioactive iodine.

Carcinoma medullary:

Either powdered buffering (struma amyloid), or parafollicular (parafollicular), accounts for less than 5% of cases, common after age 50, spread by blood and lymphatic lines, sometimes in combination with other tumours such as pheochromocytoma (Sipple's syndrome), may be familial.

U scintigraphy does not capture iodin (cold region). Diagnosis is based on quantitative increase in plasma calcitonin, post-stimulation quantification with pentatriene shows calcitonin greatly increased. Embryonic epithelial antigen (ACE) usually increases.

Thyroid cancer is not differentiated

Non-differentiated K epithelium, accounting for about 20% of cases, usually occurs later

50 years old, from a single nodule that spreads quickly to the surrounding area, causing symptoms of compression. Progressive rapidly over a few months.

X-ray showed that u did not capture iodin (cold core).

Tumour growth is affected by the concentration of TSH in the blood, when the tumour grows rapidly

TSH increase and vice versa.

Diagnose

Symptoms suggestive of thyroid K:

A nodule in the thyroid gland has increased volume, or a nodule that has existed for a long time, has recently increased in volume.

Signs of compression of neighbouring organs (mediastinal syndrome).

The cervical or superior collar enlarges gradually, firm, without pain.

Thyroid ultrasound helps to distinguish cysts from solid mass.

Thyroid scintigraphy: The result depends on the type of tumour, if detecting "cold" nucleus, it is necessary to aspirate the cytology, or biopsy for histological examination.

Prognosis

The 10-year survival rate with treatment is as follows:

80% for K papillary epithelium.

60% for K follicular epithelium.

For an undifferentiated K epithelium, the prognosis is very bad.

Treatment

Unilateral removal of the thyroid gland, when localized, or complete removal, invasive lymphadenectomy.

After surgery added radioactive iodin to the therapeutic dose and thyroid hormone with inhibited dose.

For undifferentiated K thyroid requiring extensive surgery, high dose radioactive iodine, temporary chemotherapy may be considered.

For K medullary epithelium, after total thyroid surgery, quantitative calcitonin helps detect cancer remaining tissue that has not been removed.