Overview of Surgical Pathology of the Thyroid Gland

Abstract

The purpose of this overview is to provide timely information on selected topics on the surgical pathology of the thyroid gland. Selected publications of the author and his colleagues at the University of Michigan and the Maine Medical Center form the basis of this review. Information provided in our reports is updated by perusal of recent, pertinent publications. The following questions summarize the contents of the overview. What is a "lateral aberrant thyroid"? Does it always represent metastatic carcinoma? What are dyshormogenetic goiters? Can "focal thyroiditis" in thyroid glands removed for the treatment of Graves' disease and toxic nodular goiters be predictive of the development of postoperative hypothyroidism? What is the pathology of autonomously functioning (hot) nodules? Do tall-cell, columnar-cell, and diffuse sclerosing types of papillary carcinomas forbode bad prognoses? What is the controversy over Hurthle cell tumors? Does the presence of a better differentiated component in an anaplastic thyroid carcinoma modify its biologic behavior? Are poorly differentiated carcinomas unique histologic variants? Does their histology affect prognosis? What is the most common small-cell tumor of the thyroid gland? Has the Chernobyl nuclear disaster affected the incidence of childhood thyroid carcinoma? Are these radiation-induced tumors more aggressive? The answers, some of which are controversial, are found in this overview. The aims here were to provide information to surgeons and pathologists and to improve the care of patients with thyroid disease.

Incremental Value of 131I SPECT/CT in the Management of Patients with Differentiated Thyroid Carcinoma

“…Of these, at least 94% are DTC-either papillary thyroid carcinoma or follicular thyroid carcinoma, both of which keep some of the morphologic and functional characteristics of follicular epithelium. The primary treatment of DTC is total or nearly total thyroidectomy with or without lymph node dissection (16). In the present study, all patients who had undergone total or nearly total thyroidectomy were considered to have locally advanced or metastatic disease.…”

Histopathology of Thyroid Tumors. An Overview

“…Both the tall cell and columnar cell variant are said to be more aggressive than classical papillary carcinomas 27,28 . However, recent studies suggest that the clinical behavior of these rare types of papillary carcinoma depends on tumor size, extrathyroidal invasion and distant metastases 29,30 . a.5.…”

“…Most patients are euthyroid 58 . Since MALT lymphomas characteristically metastasize to sites that contain similar tissue, it is not uncommon to see a lymphoma of the thyroid with concomitant involvement of the gastrointestinal tract 30,59 .…”

Solitary posterior triangle neck mass as the rare sole presentation of papillary thyroid carcinoma

“…The thyroid tissue which is found lateral to the carotid sheath and jugular vein can be considered as lateral aberrant thyroid+. However, most of the reported lateral aberrant thyroid cases are not fulfill this definition 6 .…”