Case year old female presented with asymmetric enlargement of the left lobe of the thyroid

Size: px
Start display at page:

Download "Case year old female presented with asymmetric enlargement of the left lobe of the thyroid"

Transcription

1 Case 4 22 year old female presented with asymmetric enlargement of the left lobe of the thyroid gland. No information available relative to a prior fine needle aspiration biopsy. A left lobectomy was performed. Intraoperative consultation diagnosis was "Follicular pattern lesion, defer to permanent section."

2

3

4

5

6

7

8

9

10 PAS

11

12

13

14

15 CK

16 TGB

17 TTF1

18 Case 4 Diagnosis - Noninvasive poorly-differentiated thyroid carcinoma - Encapsulated thyroid tumor of follicular cell origin (EFHG) with high-grade features

19 Poorly-Differentiated Thyroid Carcinoma Definition Thyroid neoplasm with histologic and biologic features intermediate between those of differentiated thyroid carcinomas and undifferentiated (anaplastic) carcinoma Synonyms: Insular Carcinoma

20 Poorly-Differentiated Thyroid Carcinoma Clinical Features Predominantly middle-aged and elderly adults (mean 54 years) F > M Enlarging neck mass: de novo preceding history of long-standing thyroid mass with transformation from differentiated carcinoma Often present with locally advanced disease

21 Poorly-Differentiated Thyroid Carcinoma Pathology Often large (>4cm), encapsulated or invasive Histopathology: insular, solid, diffuse sheets, trabeculae, festoons, follicular, papillary Cytomorphology: Uniform, small and monotonous to enlarged and pleomorphic tumor cells Coarse nuclear chromatin Increased mitotic activity and necrosis Colloid-filled follicles can be seen

22 Poorly-Differentiated Thyroid Carcinoma Pathology Continued Invasive growth including: Capsular invasion Lymph-vascular invasion Extrathyroidal extension

23

24

25

26

27

28

29

30

31

32

33

34 Poorly-Differentiated Thyroid Carcinoma Immunohistochemistry Cytokeratins, thyroglobulin and TTF1 Calcitonin negative Absence of neuroendocrine markers Bcl-2 positive Increased proliferation rate (Ki67 or MIB1)

35 CAM5.2

36 TGB

37 TTF1

38 Poorly-Differentiated Thyroid Carcinoma Turin Proposal* Presence of solid, trabecular or insular growth Absence of nuclear features diagnostic for papillary carcinoma Presence of at least one of the following: Convoluted nuclei; Mitotic activity 3 mitoses per 10 HPF; Tumor necrosis * Volante et al. AJSP 2007;31:

39 Poorly-Differentiated Thyroid Carcinoma Validation of Turin Proposal* Validate criteria for diagnosis Evaluate prevalence and prognostic behavior * Asioli et al. Modern Pathol 2010;23:

40 Poorly-Differentiated Thyroid Carcinoma Validation of Turin Proposal* 56 cases from Mayo Clinic Prevalence USA cases = 1.8% (56/2138) N. Italy = 6.7% (96/1442) Tumor characteristics similar: USA cases extensive vascular invasion (84% v 57%) N. Italy - prevalent insular growth (68% v 41%) * Asioli et al. Modern Pathol 2010;23:

41 Poorly-Differentiated Thyroid Carcinoma Validation of Turin Proposal* Overall 5- year survival: USA = 68.6% N. Italy = 73.6% Total = 71.6% Overall 10-year survival: USA = 45.9% N. Italy = 45.7% Total = 46.3% * Asioli et al. Modern Pathol 2010;23:

42 Poorly-Differentiated Thyroid Carcinoma (PDTC) PDTC not limited to tumors with insular/solid/trabecular growth: Hiltzik D, et al. Cancer 2006;106: : PDTC defined on basis of mitotic activity and/or tumor necrosis Rivera M, et al. Cancer 2008;113:48-56: Necrosis and/or mitotic index ( 5 x 10HPF)

43

44

45 Thyroid Lesions with Insular Growth Not restricted to Follicular Carcinoma: Thyroid Papillary Carcinoma Follicular Adenoma Non-neoplastic Lesions Not an indicator of: more aggressive neoplasm a neoplastic proliferation Jorda et al: Arch Pathol Lab Med : Ashfaq et al: Cancer 1994; 73:416-23

46 Poorly-Differentiated Thyroid Carcinoma Differential Diagnosis Papillary carcinoma, solid variant Thyroid medullary carcinoma Undifferentiated (anaplastic) carcinoma Benign follicular lesions/neoplasms with atypia

47 Solid Variant Papillary carcinoma > 50% solid growth Common in children including those with exposure to radiation (adults, too) Solid sheets of tumor cells with fibrovascular stroma (insular pattern) and typical nuclear features: lack increased mitotic activity, necrosis TGB, TTF1 +; CAL, NE markers negative Lymph-vascular invasion, extrathyroidal extension and nodal metastases

48

49

50 PAS

51 TGB

52 TTF1

53

54

55

56 TGB

57 TTF1

58 CAL

59 CHR

60 SYN

61

62

63 Undifferentiated (Anaplastic) Clinical Presentation: Thyroid Carcinoma Rapidly enlarging neck mass Long-standing history of thyroid-based mass Pathology: Absence of follicular differentiation by light microscopy and IHC Prognosis: Rapid death due to locally uncontrollable disease: median survival 3-4 months 5-year survival %

64

65

66

67

68

69 Poorly-Differentiated Thyroid Carcinoma Treatment and Prognosis Total thyroidectomy and radioactive iodine Extrathyroidal extension at presentation in >50% Nodal and distant metastasis at presentation in 40% and 30%, respectively Recurrence and metastasis occur after treatment in a high percentage of cases 5-year survival approximately 50% Poor prognosis: advanced age, large tumor size, extrathyroidal extension, metastasis

70 Poorly-Differentiated Thyroid Carcinoma Validation of Turin Proposal* Overall 5- year survival: USA = 68.6% N. Italy = 73.6% Total = 71.6% Overall 10-year survival: USA = 45.9% N. Italy = 45.7% Total = 46.3% * Asioli et al. Modern Pathol 2010;23:

71 Poorly-Differentiated Thyroid Carcinoma Validation of Turin Proposal* Prognosis Univariate analysis, risk of death higher: 45 years 4cm IMP3 immunoreactivity Multivariate analysis, risk of death higher: 45 years * Asioli et al. Modern Pathol 2010;23:

72 Encapsulated or Noninvasive PDTC Meets criteria of mitotic index and tumor necrosis Encapsulation (non-noninvasive)? Diagnostic terminology? Treatment? Prognosis

73 Encapsulated or Noninvasive Aggressive Thyroid Carcinomas Cell type: Columnar cell Tall cell Growth: Solid Insular

74 Encapsulated or Noninvasive Aggressive Thyroid Carcinomas Undifferentiated (Anaplastic) Carcinoma Encapsulated thyroid tumors of follicular cell origin (EFHG) with highgrade features: Rivera M, et al: Hum Pathol 2010:41:172-80

75 EFHG with High-Grade Features Diagnostic criteria: At least 5 mitoses/10 HPF Tumor necrosis

76 EFHG with High-Grade Features 25 cases: F = 17; M = 8 Age: (median, 49 years) Noninvasive = 8 (32%) Invasive = 17 (68%): Vascular: Extensive = 6 (24%); Focal = 8 (32%) Capsular: Extensive = 1 (4%); Focal = 11 (44%)

77 EFHG with High-Grade Features Size: All cases 2-7cm (mean, 3.6cm; median 3.5cm) Noninvasive: median, 3.6cm; mean 4.3cm Invasive: median, 3.2cm; mean, 3.2cm

78 EFHG with High-Grade Features Prognosis 88% (22) free of disease: Mean, 8.5 yrs; Median, 8.9 yrs Noninvasive (8): No recurrence, median follow-up 11.9 yrs

79 EFHG with High-Grade Features Invasive: Prognosis Without vascular invasion did not recur or metastasize Focal vascular invasion did not recur or metastasize Extensive vascular invasion increased risk of recurrence &/or metastasis

80 EFHG with High-Grade Features Treatment Lobectomy 48% (12/25) Total thyroidectomy: 52% (13/25) Radioactive iodine (RAI): 32% (8/25) Noninvasive 63% (5/8) total thyroidectomy 25% (2/8) RAI

81 EFHG with High-Grade Features* Noninvasive: Indolent outcome Excellent prognosis Conservative management Invasive: Tumors with extensive angioinvasion at risk of recurrence/metastasis * Rivera M, et al: Hum Pathol 2010:41:172-80

82 Poorly-Differentiated Thyroid Carcinoma Conclusion Distinct entity defined by histologic features that may not include insular/solid growth Oncocytic variant of PDTC Biologic behavior that is distinct and intermediate between differentiated thyroid carcinomas and undifferentiated (anaplastic) carcinoma

83 Rare Noninvasive EFHG with High-Grade Features Meet criteria of mitotic index and tumor necrosis Adverse effect that tumor necrosis and high mitotic rate have on survival in invasive thyroid carcinomas does not hold true in encapsulated noninvasive tumors Conservative treatment Excellent prognosis

84 EFHG with High-Grade Features Molecular Genetics Mutations found in 45% (10/22): 8 NRAS codon 61 1 KRAS codon 61 1 BRAF V600E and AKT1 2 PAX8-PPARγ rearrangements No RET rearrangement Higher frequency of RAS (41%) than BRAF (4.5%) Mutational rate significantly higher in patients > 45 years (P =.042)

85 Noninvasive EFHG with High-Grade Features Preinvasive precursors of thyroid carcinomas Low-stage PDTC With necrosis Thyroid carcinoma With mitoses Follicular adenoma (with atypia)

86 Case 4 Diagnosis - Noninvasive Poorly-Differentiated Thyroid Carcinoma - Encapsulated thyroid tumor of follicular cell origin (EFHG) with high-grade features

Case 4 Diagnosis 2/21/2011 TGB

Case 4 Diagnosis 2/21/2011 TGB Case 4 22 year old female presented with asymmetric enlargement of the left lobe of the thyroid gland. No information available relative to a prior fine needle aspiration biopsy. A left lobectomy was performed.

More information

AGGRESSIVE VARIANTS OF PAPILLARY THYROID CARCINOMA DIAGNOSIS AND PROGNOSIS

AGGRESSIVE VARIANTS OF PAPILLARY THYROID CARCINOMA DIAGNOSIS AND PROGNOSIS AGGRESSIVE VARIANTS OF PAPILLARY THYROID CARCINOMA DIAGNOSIS AND PROGNOSIS PAPILLARY THYROID CARCINOMA Clinical Any age Microscopic to large Female: Male= 2-4:1 Radiation history Lymph nodes Prognosis

More information

Pathology of the Thyroid

Pathology of the Thyroid Pathology of the Thyroid Thyroid Carcinoma Arising from Follicular Cells 2015-01-19 Prof. Dr. med. Katharina Glatz Pathologie Carcinomas Arising from Follicular Cells Differentiated Carcinoma Papillary

More information

POORLY DIFFERENTIATED, HIGH GRADE AND ANAPLASTIC CARCINOMAS: WHAT IS EVERYONE TALKING ABOUT?

POORLY DIFFERENTIATED, HIGH GRADE AND ANAPLASTIC CARCINOMAS: WHAT IS EVERYONE TALKING ABOUT? POORLY DIFFERENTIATED, HIGH GRADE AND ANAPLASTIC CARCINOMAS: WHAT IS EVERYONE TALKING ABOUT? AGGRESSIVE THYROID CANCERS PAPILLARY CARCINOMA CERTAIN SUBTYPES POORLY DIFFERENTIATED CARCINOMA HIGH GRADE DIFFERENTIATED

More information

An Alphabet Soup of Thyroid Neoplasms

An Alphabet Soup of Thyroid Neoplasms Overall Objectives An Alphabet Soup of Thyroid Neoplasms Lester D. R. Thompson www.lester-thompson.com What is the current management of papillary carcinoma? What are the trends and what can we do differently?

More information

Follicular Derived Thyroid Tumors

Follicular Derived Thyroid Tumors Follicular Derived Thyroid Tumors Jennifer L. Hunt, MD, MEd Aubrey J. Hough Jr, MD, Endowed Professor of Pathology Chair of Pathology and Laboratory Medicine University of Arkansas for Medical Sciences

More information

New entities in thyroid pathology: update according to the WHO classification

New entities in thyroid pathology: update according to the WHO classification New entities in thyroid pathology: update according to the WHO classification R.R. de Krijger, Dept. of Pathology, University Medical Center and Princess Maxima Center, Utrecht, The Netherlands New issues

More information

04/09/2018. Follicular Thyroid Tumors Updates in Classification & Practical Tips. Dissecting Indeterminants. In pursuit of the low grade malignancy

04/09/2018. Follicular Thyroid Tumors Updates in Classification & Practical Tips. Dissecting Indeterminants. In pursuit of the low grade malignancy Follicular Thyroid Tumors Updates in Classification & Practical Tips Jennifer L. Hunt, MD, MEd Aubrey J. Hough Jr, MD, Endowed Professor of Pathology Chair of Pathology and Laboratory Medicine University

More information

Thyroid Pathology: It starts and ends with the gross. Causes of Thyrophobia. Agenda. Diagnostic ambiguity. Treatment/prognosis disconnect

Thyroid Pathology: It starts and ends with the gross. Causes of Thyrophobia. Agenda. Diagnostic ambiguity. Treatment/prognosis disconnect Thyroid Pathology: It starts and ends with the gross Jennifer L. Hunt, MD, MEd Aubrey J. Hough Jr, MD, Endowed Professor of Pathology Chair of Pathology and Laboratory Medicine University of Arkansas for

More information

NIFTP: Histopathology of a Cytological Monkey Wrench. B. Wehrli

NIFTP: Histopathology of a Cytological Monkey Wrench. B. Wehrli NIFTP: Histopathology of a Cytological Monkey Wrench B. Wehrli Non-Invasive Encapsulated Follicular Variant of Papillary Thyroid Carcinoma Before 2016 Non-Invasive Follicular Thyroid Neoplasm with Papillary-Like

More information

Ultrasound-Guided Fine-Needle Aspiration of Thyroid Nodules: New events

Ultrasound-Guided Fine-Needle Aspiration of Thyroid Nodules: New events Ultrasound-Guided Fine-Needle Aspiration of Thyroid Nodules: New events Sandrine Rorive, M.D., PhD. Erasme Hospital - Université Libre de Bruxelles (ULB) INTRODUCTION The assessment of thyroid nodules

More information

TBSRTC 1- Probabilistic approach and Relationship to Clinical Algorithms

TBSRTC 1- Probabilistic approach and Relationship to Clinical Algorithms The Benefits of a Uniform Reporting System for Thyroid Cytopathology BETHESDA REPORTING SYSTEM Prof. Fernando Schmitt Department of Pathology and Oncology, Medical Faculty of Porto University Head of Molecular

More information

FNA of Thyroid. Toward a Uniform Terminology With Management Guidelines. NCI NCI Thyroid FNA State of the Science Conference

FNA of Thyroid. Toward a Uniform Terminology With Management Guidelines. NCI NCI Thyroid FNA State of the Science Conference FNA of Thyroid NCI NCI Thyroid FNA State of the Science Conference Toward a Uniform Terminology With Management Guidelines Thyroid Thyroid FNA Cytomorphology NCI Thyroid FNA State of the Science Conference

More information

Update on Thyroid FNA The Bethesda System. Shikha Bose M.D. Associate Professor Cedars Sinai Medical Center

Update on Thyroid FNA The Bethesda System. Shikha Bose M.D. Associate Professor Cedars Sinai Medical Center Update on Thyroid FNA The Bethesda System Shikha Bose M.D. Associate Professor Cedars Sinai Medical Center Thyroid Nodules Frequent occurrence Palpable: 4-7% of adults Ultrasound: 10-31% Majority benign

More information

Normal thyroid tissue

Normal thyroid tissue Thyroid Pathology Overview Normal thyroid tissue Normal thyroid tissue with follicles filled with colloid. Thyroid cells form follicles, spheres of epithelial cells (always single layered in health, usually

More information

encapsulated thyroid nodule with a follicular architecture and some form of atypia. The problem is when to diagnose

encapsulated thyroid nodule with a follicular architecture and some form of atypia. The problem is when to diagnose Histological Spectrum of Papillary Carcinoma of Thyroid A Two Years Study Gomathi Srinivasan 1, M. Vennila 2 1 Associate Professor Pathology, Government Medical College, Omandurar Estate, Chennai 600 002

More information

- RET/PTC rearrangement: 20% papillary thyroid cancer - RET: medullary thyroid cancer

- RET/PTC rearrangement: 20% papillary thyroid cancer - RET: medullary thyroid cancer Thyroid Cancer UpToDate: Introduction: Risk Factors: Biology: Symptoms: Diagnosis: 1. Lenvina is the first line therapy with powerful durable response and superior PFS in pts with RAI-refractory disease.

More information

Case #1 FNA of nodule in left lobe of thyroid in 67 y.o. woman

Case #1 FNA of nodule in left lobe of thyroid in 67 y.o. woman Challenging Cases Manon Auger M.D., F.R.C.P. (C) Professor, Department of Pathology McGill University Director, Cytopathology Laboratory McGill University it Health Center Case #1 FNA of nodule in left

More information

Goiter, Nodules and Tumors

Goiter, Nodules and Tumors Goiter, Nodules and Tumors Howard J. Sachs, MD www.12daysinmarch.com Thyroid Cancer Anaplastic Medullary Thyroid Cancer Anaplastic Medullary Thyroid Cancer Anaplastic Medullary Anaplastic Medullary MEN

More information

CAP Cancer Protocol and ecc Summary of Changes for August 2014 Thyroid Agile Release

CAP Cancer Protocol and ecc Summary of Changes for August 2014 Thyroid Agile Release CAP Cancer Protocol and ecc Summary of Changes for August 2014 Thyroid Agile Release 2 REVISION HISTORY Date Author / Editor Comments 5/19/2014 Jaleh Mirza Created the document 8/12/2014 Samantha Spencer/Jaleh

More information

Neuroendocrine neoplasms of the lung

Neuroendocrine neoplasms of the lung Neuroendocrine neoplasms of the lung M Papotti, L Righi, & M Volante University of Turin at San Luigi Hospital TORINO NETs OF THE LUNG Menu - Spectrum of NE lung tumors - CARCINOID TUMORS - SCLC /LCNEC

More information

B. Environmental Factors. a. The major risk factor to papillary thyroid cancer is exposure to ionizing radiation, during the first 2 decades of life.

B. Environmental Factors. a. The major risk factor to papillary thyroid cancer is exposure to ionizing radiation, during the first 2 decades of life. B. Environmental Factors. a. The major risk factor to papillary thyroid cancer is exposure to ionizing radiation, during the first 2 decades of life. b. Deficiency of dietary iodine: - Is linked with a

More information

Thyroid pathology Practical part

Thyroid pathology Practical part Thyroid pathology Practical part My Algorithm After a good macroscopy and a microscopic overview of the lesion, I especially look at the capsule and the thyroid just above and just beneath the capsule.

More information

Pitfalls in thyroid tumor pathology. Prof.Valdi Pešutić-Pisac MD, PhD

Pitfalls in thyroid tumor pathology. Prof.Valdi Pešutić-Pisac MD, PhD Pitfalls in thyroid tumor pathology Prof.Valdi Pešutić-Pisac MD, PhD Too many or... Tumour herniation through a torn capsule simulating capsular invasion fibrous capsule with a sharp discontinuity, suggestive

More information

2015 American Thyroid Association Thyroid Nodule and Cancer Guidelines

2015 American Thyroid Association Thyroid Nodule and Cancer Guidelines 2015 American Thyroid Association Thyroid Nodule and Cancer Guidelines Angela M. Leung, MD, MSc, ECNU November 5, 2016 Outline Workup of nontoxic thyroid nodule(s) Ultrasound FNAB Management of FNAB results

More information

THE FOLLICULAR VARIANT OF PAPILLARY THYROID CARCINOMA AND NIFTP

THE FOLLICULAR VARIANT OF PAPILLARY THYROID CARCINOMA AND NIFTP THE FOLLICULAR VARIANT OF PAPILLARY THYROID CARCINOMA AND NIFTP FOLLICULAR VARIANT OF PAPILLARY CARCINOMA HISTORICAL PERSPECTIVE FOLLICULAR VARIANT OF PAPILLARY CARCINOMA 1960 described by Dr. Stuart Lindsay

More information

THYMIC CARCINOMAS AN UPDATE

THYMIC CARCINOMAS AN UPDATE THYMIC CARCINOMAS AN UPDATE Mark R. Wick, M.D. University of Virginia Medical Center Charlottesville, VA CARCINOMA OF THE THYMUS General Clinical Features No apparent gender predilection Age range of 35-75

More information

Management guideline for patients with differentiated thyroid cancer. Teeraporn Ratanaanekchai ENT, KKU 17 October 2007

Management guideline for patients with differentiated thyroid cancer. Teeraporn Ratanaanekchai ENT, KKU 17 October 2007 Management guideline for patients with differentiated thyroid Teeraporn Ratanaanekchai ENT, KKU 17 October 2007 Incidence (Srinagarind Hospital, 2005, both sex) Site (all) cases % 1. Liver 1178 27 2. Lung

More information

CN 925/15 History. Microscopic Findings

CN 925/15 History. Microscopic Findings CN 925/15 History 78 year old female. FNA indeterminate lesion right thyroid lobe. Previous THY1C (UK) Bethesda category 1 cyst fluid. Ultrasound showed part solid/cystic changes, indeterminate in nature

More information

Poorly differentiated carcinoma of the thyroid: validation of the Turin proposal and analysis of IMP3 expression

Poorly differentiated carcinoma of the thyroid: validation of the Turin proposal and analysis of IMP3 expression & 2010 USCAP, Inc. All rights reserved 0893-3952/10 $32.00 1269 Poorly differentiated carcinoma of the thyroid: validation of the Turin proposal and analysis of IMP3 expression Sofia Asioli 1,2, Lori A

More information

Thyroid follicular neoplasms in cytology. Ulrika Klopčič Institute of Oncology, Department of Cytopathology, Ljubljana, Slovenia

Thyroid follicular neoplasms in cytology. Ulrika Klopčič Institute of Oncology, Department of Cytopathology, Ljubljana, Slovenia Thyroid follicular neoplasms in cytology Ulrika Klopčič Institute of Oncology, Department of Cytopathology, Ljubljana, Slovenia Lecture overview importance of FNAB in assessing thyroid lesions follicular

More information

Dilemmas in Cytopathology and Histopathology

Dilemmas in Cytopathology and Histopathology Dilemmas in Cytopathology and Histopathology Yuri E. Nikiforov, MD, PhD Division of Molecular & Genomic Pathology University of Pittsburgh Medical Center, USA Objectives Discuss new WHO classification

More information

NEOPLASMS OF THE THYROID PATHOLOGY OF PARATHYROID GLANDS. BY: Shifaa Qa qa

NEOPLASMS OF THE THYROID PATHOLOGY OF PARATHYROID GLANDS. BY: Shifaa Qa qa NEOPLASMS OF THE THYROID PATHOLOGY OF PARATHYROID GLANDS BY: Shifaa Qa qa Neoplasmas of the thyroid thyroid nodules Neoplastic ---- benign, malignant Non neoplastic Solitary nodules ----- neoplastic Nodules

More information

Thyroid Gland. Protocol applies to all malignant tumors of the thyroid gland, except lymphomas.

Thyroid Gland. Protocol applies to all malignant tumors of the thyroid gland, except lymphomas. Thyroid Gland Protocol applies to all malignant tumors of the thyroid gland, except lymphomas. Procedures Cytology (No Accompanying Checklist) Partial Thyroidectomy Total Thyroidectomy With/Without Lymph

More information

Thyroid master class. Thyroid Fine needle aspiration cytology and liquid-based techniques: Hologic and Becton Dickinson

Thyroid master class. Thyroid Fine needle aspiration cytology and liquid-based techniques: Hologic and Becton Dickinson Thyroid master class Thyroid Fine needle aspiration cytology and liquid-based techniques: Hologic and Becton Dickinson Principle of LBC Collection of cells in liquid medium Immediate fixation Processor-prepared

More information

Clinical and Molecular Approach to Using Thyroid Needle Biopsy for Nodular Disease

Clinical and Molecular Approach to Using Thyroid Needle Biopsy for Nodular Disease Clinical and Molecular Approach to Using Thyroid Needle Biopsy for Nodular Disease Robert L. Ferris, MD, PhD Department of Otolaryngology/Head and Neck Surgery and Yuri E. Nikiforov, MD, PhD Division of

More information

Case Scenario 1: Thyroid

Case Scenario 1: Thyroid Case Scenario 1: Thyroid History and Physical Patient is an otherwise healthy 80 year old female with the complaint of a neck mass first noticed two weeks ago. The mass has increased in size and is palpable.

More information

Case Report Tumor-to-Tumor Metastasis: Lung Carcinoma Metastasizing to Thyroid Neoplasms

Case Report Tumor-to-Tumor Metastasis: Lung Carcinoma Metastasizing to Thyroid Neoplasms Hindawi Publishing Corporation Volume 2015, Article ID 153932, 5 pages http://dx.doi.org/10.1155/2015/153932 Case Report Tumor-to-Tumor Metastasis: Lung Carcinoma Metastasizing to Thyroid Neoplasms Shiuan-Li

More information

Thyroid Cancer: When to Treat? MEGAN R. HAYMART, MD

Thyroid Cancer: When to Treat? MEGAN R. HAYMART, MD Thyroid Cancer: When to Treat? MEGAN R. HAYMART, MD ASSOCIATE PROFESSOR OF MEDICINE UNIVERSITY OF MICHIGAN MICHIGAN AACE 2018 ANNUAL MEETING Thyroid Cancer: When Not to Treat? FOCUS WILL BE ON LOW-RISK

More information

The Frozen Section: Diagnostic Challenges and Pitfalls

The Frozen Section: Diagnostic Challenges and Pitfalls The Frozen Section: Diagnostic Challenges and Pitfalls William C. Faquin, M.D., Ph.D. Director, Head and Neck Pathology Massachusetts General Hospital & Massachusetts Eye and Ear Infirmary Harvard Medical

More information

Thyroid Nodules. Dr. HAKIMI, SpAK Dr. MELDA DELIANA, SpAK Dr. SISKA MAYASARI LUBIS, SpA

Thyroid Nodules. Dr. HAKIMI, SpAK Dr. MELDA DELIANA, SpAK Dr. SISKA MAYASARI LUBIS, SpA Thyroid Nodules ENDOCRINOLOGY DIVISION ENDOCRINOLOGY DIVISION Dr. HAKIMI, SpAK Dr. MELDA DELIANA, SpAK Dr. SISKA MAYASARI LUBIS, SpA Anatomical Considerations The Thyroid Nodule Congenital anomalies Thyroglossal

More information

Case Report Tumor-to-Tumor Metastasis: Lung Carcinoma Metastasizing to Thyroid Neoplasms

Case Report Tumor-to-Tumor Metastasis: Lung Carcinoma Metastasizing to Thyroid Neoplasms Case Reports in Pathology Volume 2015, Article ID 153932, 5 pages http://dx.doi.org/10.1155/2015/153932 Case Report Tumor-to-Tumor Metastasis: Lung Carcinoma Metastasizing to Thyroid Neoplasms Shiuan-Li

More information

Management of Thyroid Nodules

Management of Thyroid Nodules Management of Thyroid Nodules 38 y/o female with solid 1.5 cm right Thyroid nodule. TSH=0.68 Vincent J. Reid, MD., FACS Thyroid Cancer Incidence & Mortality 1974 to 2004 Overall Women Men Mortality 1 Cancer

More information

My personal experience at University of Toronto and recent updates of

My personal experience at University of Toronto and recent updates of My personal experience at University of Toronto and recent updates of Endocrine Pathology Toshitetsu Hayashi M.D. Ph.D. ¹Department of Diagnostic Pathology, Takamatsu Red Cross Hospital, Japan ²Laboratory

More information

The International Federation of Head and Neck Oncologic Societies. Current Concepts in Head and Neck Surgery and Oncology

The International Federation of Head and Neck Oncologic Societies. Current Concepts in Head and Neck Surgery and Oncology The International Federation of Head and Neck Oncologic Societies Current Concepts in Head and Neck Surgery and Oncology www.ifhnos.net The International Federation of Head and Neck Oncologic Societies

More information

Evaluation and Management of Thyroid Nodules. Nick Vernetti, MD, FACE Palm Medical Group Las Vegas, Nevada

Evaluation and Management of Thyroid Nodules. Nick Vernetti, MD, FACE Palm Medical Group Las Vegas, Nevada Evaluation and Management of Thyroid Nodules Nick Vernetti, MD, FACE Palm Medical Group Las Vegas, Nevada Disclosure Consulting Amgen Speaking Amgen Objectives Understand the significance of incidental

More information

NIFTP addendum to the RCPath Dataset for thyroid cancer histopathology reports. June 2016

NIFTP addendum to the RCPath Dataset for thyroid cancer histopathology reports. June 2016 NIFTP addendum to the RCPath Dataset for thyroid cancer histopathology reports June 2016 Authors: Dr Sarah J Johnson, Royal Victoria Infirmary, Newcastle upon Tyne Professor TJ Stephenson, Sheffield Teaching

More information

Thyroid Nodules. Family Medicine Refresher Course Geeta Lal MD, FACS April 2, No financial disclosures

Thyroid Nodules. Family Medicine Refresher Course Geeta Lal MD, FACS April 2, No financial disclosures Thyroid Nodules Family Medicine Refresher Course Geeta Lal MD, FACS April 2, 2014 No financial disclosures Objectives Review epidemiology Work up of Thyroid nodules Indications for FNAB Evolving role of

More information

Update to the College of American Pathologists Reporting on Thyroid Carcinomas

Update to the College of American Pathologists Reporting on Thyroid Carcinomas Head and Neck Pathol (2009) 3:86 93 DOI 10.1007/s12105-009-0109-2 PROCEEDINGS OF THE 2009 NORTH AMERICAN SOCIETY OF HEAD AND NECK PATHOLOGY COMPANION MEETING (BOSTON, MA) Update to the College of American

More information

Salivary Glands 3/7/2017

Salivary Glands 3/7/2017 Salivary Glands 3/7/2017 Goals and objectives Focus on the entities unique to H&N Common board type facts Information for your future practice Salivary Glands Salivary Glands Major gland. Paratid. Submandibular.

More information

Research Article Papillary Thyroid Cancer, Macrofollicular Variant: The Follow-Up and Analysis of Prognosis of 5 Patients

Research Article Papillary Thyroid Cancer, Macrofollicular Variant: The Follow-Up and Analysis of Prognosis of 5 Patients yroid Research, Article ID 818134, 4 pages http://dx.doi.org/10.1155/2014/818134 Research Article Papillary Thyroid Cancer, Macrofollicular Variant: The Follow-Up and Analysis of Prognosis of 5 Patients

More information

Background to the Thyroid Nodule

Background to the Thyroid Nodule William C. Faquin, MD, PhD Professor of Pathology Harvard Medical School Director of Head and Neck Pathology Massachusetts Eye and Ear Massachusetts General Hospital THYROID FNA: PART I Background to the

More information

Neoplasias Quisticas del Páncreas

Neoplasias Quisticas del Páncreas SEAP -Aproximación Práctica a la Patología Gastrointestinal- Madrid, 26 de mayo, 2006 Neoplasias Quisticas del Páncreas Gregory Y. Lauwers, M.D. Director, Service Massachusetts General Hospital Harvard

More information

Non-Invasive Follicular Thyroid Neoplasm with Papillary-like Nuclei (NIFTP)

Non-Invasive Follicular Thyroid Neoplasm with Papillary-like Nuclei (NIFTP) Papillary Thyroid Carcinoma: Follicular Variant Encapsulated Type Replaced by: Non-Invasive Follicular Thyroid Neoplasm with Papillary-like Nuclei (NIFTP) Lester D. R. Thompson www.lester-thompson.com

More information

Neuroendocrine Lung Tumors Myers

Neuroendocrine Lung Tumors Myers Diagnosis and Classification of Neuroendocrine Lung Tumors Jeffrey L. Myers, M.D. A. James French Professor Director, Anatomic Pathology & MLabs University of Michigan, Ann Arbor, MI myerjeff@umich.edu

More information

G3.02 The malignant potential of the neoplasm should be recorded. CG3.02a

G3.02 The malignant potential of the neoplasm should be recorded. CG3.02a G3.02 The malignant potential of the neoplasm should be recorded. CG3.02a Conventional adrenocortical neoplasm. Each of the below parameters is scored 0 when absent and 1 when present. 3 or more of these

More information

Squamous Cell Carcinoma of Thyroid: possible thymic origin, so-called ITET/CASTLE 2012/03/22

Squamous Cell Carcinoma of Thyroid: possible thymic origin, so-called ITET/CASTLE 2012/03/22 Squamous Cell Carcinoma of Thyroid: possible thymic origin, so-called ITET/CASTLE 2012/03/22 History of ITET/CASTLE First Report Gross Appearance and Prognosis 1) Miyauchi A et al: Intrathyroidal epithelial

More information

Carcinoma mammario: le istologie non frequenti. Valentina Guarneri Università di Padova IOV-IRCCS

Carcinoma mammario: le istologie non frequenti. Valentina Guarneri Università di Padova IOV-IRCCS Carcinoma mammario: le istologie non frequenti Valentina Guarneri Università di Padova IOV-IRCCS Histological diversity of breast adenocarcinomas Different histological types are defined according to specific

More information

DIAGNOSTIC SLIDE SEMINAR: PART 1 RENAL TUMOUR BIOPSY CASES

DIAGNOSTIC SLIDE SEMINAR: PART 1 RENAL TUMOUR BIOPSY CASES DIAGNOSTIC SLIDE SEMINAR: PART 1 RENAL TUMOUR BIOPSY CASES Dr. Andrew J. Evans MD, PhD, FACP, FRCPC Consultant in Genitourinary Pathology University Health Network, Toronto, ON Case 1 43 year-old female,

More information

Hyalinizing Trabecular Neoplasm of the Thyroid: Controversies in Management

Hyalinizing Trabecular Neoplasm of the Thyroid: Controversies in Management ISPUB.COM The Internet Journal of Endocrinology Volume 2 Number 1 Hyalinizing Trabecular Neoplasm of the Thyroid: Controversies in Management J D'Elia, D Charous, J Miller, J Palazzo, E Pribitkin Citation

More information

Thyroid nodules - medical and surgical management. Endocrinology and Endocrine Surgery Manchester Royal Infirmary

Thyroid nodules - medical and surgical management. Endocrinology and Endocrine Surgery Manchester Royal Infirmary Thyroid nodules - medical and surgical management JRE Davis NR Parrott Endocrinology and Endocrine Surgery Manchester Royal Infirmary Thyroid nodules - prevalence Thyroid nodules common, increase with

More information

THYROID CANCER IN CHILDREN. Humberto Lugo-Vicente MD FACS FAAP Professor Pediatric Surgery UPR School of Medicine

THYROID CANCER IN CHILDREN. Humberto Lugo-Vicente MD FACS FAAP Professor Pediatric Surgery UPR School of Medicine THYROID CANCER IN CHILDREN Humberto Lugo-Vicente MD FACS FAAP Professor Pediatric Surgery UPR School of Medicine Thyroid nodules Rare Female predominance 4-fold as likely to be malignant Hx Radiation exposure?

More information

Distant and Lymph Node Metastases of Thyroid Nodules with No Pathological Evidence of Malignancy: A Limitation of Pathological Examination

Distant and Lymph Node Metastases of Thyroid Nodules with No Pathological Evidence of Malignancy: A Limitation of Pathological Examination Endocrine Journal 2008, 55 (5), 889 894 Distant and Lymph Node Metastases of Thyroid Nodules with No Pathological Evidence of Malignancy: A Limitation of Pathological Examination YASUHIRO ITO, TOMONORI

More information

10/24/2008. Surgery for Well-differentiated Thyroid Carcinoma- The Primary

10/24/2008. Surgery for Well-differentiated Thyroid Carcinoma- The Primary Surgery for Well-differentiated Thyroid Carcinoma- The Primary Head and Neck Endocrine Surgery Department of Otolaryngology-Head and Neck Surgery, UCSF October 24-25, 2008 Robert A. Sofferman, MD Professor

More information

Thyroid Nodule. Disclosure. Learning Objectives P A P A P A 3/18/2014. Nothing to disclose.

Thyroid Nodule. Disclosure. Learning Objectives P A P A P A 3/18/2014. Nothing to disclose. Thyroid Nodule Evaluating the patient with a thyroid nodule and some management options. Miguel V. Valdez PA C Disclosure Nothing to disclose. Learning Objectives Examination of thyroid gland Options for

More information

Pancreatic Cytopathology: The Solid Neoplasms

Pancreatic Cytopathology: The Solid Neoplasms Pancreatic Cytopathology: The Solid Neoplasms Syed Z. Ali, M.D. Professor of Pathology and Radiology Director of Cytopathology The Johns Hopkins Hospital Baltimore, Maryland Pancreatic Cytopathology: Past,

More information

Disclosures. Parathyroid Pathology. Objectives. The normal parathyroid 11/10/2012

Disclosures. Parathyroid Pathology. Objectives. The normal parathyroid 11/10/2012 Disclosures Parathyroid Pathology I have nothing to disclose Annemieke van Zante MD/PhD Assistant Professor of Clinical Pathology Associate Chief of Cytopathology Objectives 1. Review the pathologic features

More information

5/3/2017. Ahn et al N Engl J Med 2014; 371

5/3/2017. Ahn et al N Engl J Med 2014; 371 Alan Failor, M.D. Clinical Professor of Medicine Division of Metabolism, Endocrinology and Nutrition University of Washington April 20, 2017 No disclosures to report 1. Appropriately evaluate s in adult

More information

Page 289. Corresponding Author: Dr. Nitya Subramanian, Volume 3 Issue - 5, Page No

Page 289. Corresponding Author: Dr. Nitya Subramanian, Volume 3 Issue - 5, Page No ISSN- O: 2458-868X, ISSN P: 2458 8687 Index Copernicus Value: 49. 23 PubMed - National Library of Medicine - ID: 101731606 SJIF Impact Factor: 4.956 International Journal of Medical Science and Innovative

More information

40 TH EUROPEAN CONGRESS 0F CYTOLOGY LIVERPOOL, UK October 2-5, 2016

40 TH EUROPEAN CONGRESS 0F CYTOLOGY LIVERPOOL, UK October 2-5, 2016 Outcomes from the diagnostic approach of thyroid lesions using US-FNA and LBC in clinical practice Emmanouel Mastorakis MD PhD Cytopathologist Director in Cytopathology Laboratory Regional General Hospital

More information

Thyroid FNA: Diagnosis, Challenges and Solutions. Disclosures

Thyroid FNA: Diagnosis, Challenges and Solutions. Disclosures Thyroid FNA: Diagnosis, Challenges and Solutions Zubair W. Baloch, MD, PhD None Disclosures 1 Questions to Myself? Where We are Now? The Present 2 Reality Check There is More to How Thyroid Nodules are

More information

Genomic landsccape of poorly differentiated and anaplastic thyroid carcinomas: Clues for better classification, risk stratification and therapy

Genomic landsccape of poorly differentiated and anaplastic thyroid carcinomas: Clues for better classification, risk stratification and therapy ACCME/Disclosures The USCAP requires that anyone in a position to influence or control the content of CME disclose any relevant financial relationship WITH COMMERCIAL INTERESTS which they or their spouse/partner

More information

ACCME/Disclosures. Diagnosing Mesothelioma in Limited Tissue Samples. Papanicolaou Society of Cytopathology Companion Meeting March 12 th, 2016

ACCME/Disclosures. Diagnosing Mesothelioma in Limited Tissue Samples. Papanicolaou Society of Cytopathology Companion Meeting March 12 th, 2016 Diagnosing Mesothelioma in Limited Tissue Samples Papanicolaou Society of Cytopathology Companion Meeting March 12 th, 2016 Sanja Dacic, MD, PhD University of Pittsburgh ACCME/Disclosures GENERAL RULES

More information

Anaplastic Transformation of Papillary Thyroid Carcinoma in a Young Man: A Case Study with Immunohistochemical and BRAF Analysis

Anaplastic Transformation of Papillary Thyroid Carcinoma in a Young Man: A Case Study with Immunohistochemical and BRAF Analysis The Korean Journal of Pathology 2014; 48: 234-240 CASE STUDY Anaplastic Transformation of Papillary Thyroid Carcinoma in a Young Man: A Case Study with Immunohistochemical and BRAF Analysis Ji Hye Park

More information

Update in Salivary Gland Pathology. Benjamin L. Witt University of Utah/ARUP Laboratories February 9, 2016

Update in Salivary Gland Pathology. Benjamin L. Witt University of Utah/ARUP Laboratories February 9, 2016 Update in Salivary Gland Pathology Benjamin L. Witt University of Utah/ARUP Laboratories February 9, 2016 Objectives Review the different appearances of a selection of salivary gland tumor types Establish

More information

Medullary Thyroid Carcinoma. This case was provided by Treant Hospital, Bethesda, Hoogeveen, The Netherlands

Medullary Thyroid Carcinoma. This case was provided by Treant Hospital, Bethesda, Hoogeveen, The Netherlands Medullary Thyroid Carcinoma This case was provided by Treant Hospital, Bethesda, Hoogeveen, The Netherlands ADS-01504 Rev. 001 2016 Hologic, Inc. All rights reserved. Overview Medullary Thyroid Carcinoma

More information

Disclosure. Relevant Financial Relationship(s) None. Off Label Usage None MFMER slide-1

Disclosure. Relevant Financial Relationship(s) None. Off Label Usage None MFMER slide-1 Disclosure Relevant Financial Relationship(s) None Off Label Usage None 2013 MFMER slide-1 Case Presentation A 43 year old male, with partial nephrectomy for a right kidney mass 2013 MFMER slide-2 2013

More information

4/22/2010. Hakan Korkmaz, MD Assoc. Prof. of Otolaryngology Ankara Dıșkapı Training Hospital-Turkey.

4/22/2010. Hakan Korkmaz, MD Assoc. Prof. of Otolaryngology Ankara Dıșkapı Training Hospital-Turkey. Management of Differentiated Thyroid Cancer: Head Neck Surgeon Perspective Hakan Korkmaz, MD Assoc. Prof. of Otolaryngology Ankara Dıșkapı Training Hospital-Turkey Thyroid gland Small endocrine gland:

More information

Cytological Sub-classification of Lung Cancer: Morphologic and Molecular Characteristics. Mercè Jordà, University of Miami

Cytological Sub-classification of Lung Cancer: Morphologic and Molecular Characteristics. Mercè Jordà, University of Miami Cytological Sub-classification of Lung Cancer: Morphologic and Molecular Characteristics Mercè Jordà, University of Miami Mortality Lung cancer is the most frequent cause of cancer incidence and mortality

More information

:Well differentiated tumour of uncertain malignant potential. : Encapsulated follicular variant of papillary thyroid carcinoma

:Well differentiated tumour of uncertain malignant potential. : Encapsulated follicular variant of papillary thyroid carcinoma WDC-NOS (Well-Differentiated Carcinoma, not otherwise specified): An encapsulated tumor of well-differentiated follicular cells showing obvious capsular and/or blood vessel invasion and having questionable

More information

New York, the nation s thyroid gland. Christopher Morley ( ), "Shore Leave"

New York, the nation s thyroid gland. Christopher Morley ( ), Shore Leave New York, the nation s thyroid gland Christopher Morley (1890-1957), "Shore Leave" Thyroid Literature Medline Thyroid disease 136,053 Thyroid tumors 33,554 New Paper on Thyroid Disease Every 3 Hours New

More information

THYROID CYTOLOGY THYROID CYTOLOGY FINE-NEEDLE-ASPIRATION ANCILLARY TESTS IN THYROID FNA

THYROID CYTOLOGY THYROID CYTOLOGY FINE-NEEDLE-ASPIRATION ANCILLARY TESTS IN THYROID FNA ANCILLARY TESTS IN THYROID FNA Prof. Fernando Schmitt Department of Pathology and Oncology, Medical Faculty of Porto University Head of Molecular Pathology Unit, IPATIMUP General-Secretary of the International

More information

International Society of Gynecological Pathologists Symposium 2007

International Society of Gynecological Pathologists Symposium 2007 International Society of Gynecological Pathologists Symposium 2007 Anais Malpica, M.D. Department of Pathology The University of Texas M.D. Anderson Cancer Center Grading of Ovarian Cancer Histologic grade

More information

Triple Negative Breast Cancer

Triple Negative Breast Cancer Triple Negative Breast Cancer Prof. Dr. Pornchai O-charoenrat Division of Head-Neck & Breast Surgery Department of Surgery Faculty of Medicine Siriraj Hospital Breast Cancer Classification Traditional

More information

Noninvasive follicular thyroid neoplasm with papillary-like nuclear features: a single-institutional experience in Japan

Noninvasive follicular thyroid neoplasm with papillary-like nuclear features: a single-institutional experience in Japan 2017, 64 (12), 1149-1155 Original Noninvasive follicular thyroid neoplasm with papillary-like nuclear features: a single-institutional experience in Japan Mitsuyoshi Hirokawa 1), Miyoko Higuchi 2), Ayana

More information

Calcitonin. 1

Calcitonin.  1 Calcitonin Medullary thyroid carcinoma (MTC) is characterized by a high concentration of serum calcitonin. Routine measurement of serum calcitonin concentration has been advocated for detection of MTC

More information

Presentation material is for education purposes only. All rights reserved URMC Radiology Page 1 of 98

Presentation material is for education purposes only. All rights reserved URMC Radiology Page 1 of 98 Presentation material is for education purposes only. All rights reserved. 2011 URMC Radiology Page 1 of 98 Radiology / Pathology Conference February 2011 Brooke Koltz, Cytopathology Resident Presentation

More information

Non Small Cell Lung Cancer Histopathology ד"ר יהודית זנדבנק

Non Small Cell Lung Cancer Histopathology דר יהודית זנדבנק Non Small Cell Lung Cancer Histopathology ד"ר יהודית זנדבנק 26.06.09 Lecture outlines WHO histological classification Macro/Micro assessment Early diagnosis Minimal pathology Main subtypes SCC, AdCa, LCLC

More information

Rossella Elisei. Department of Endocrinology, University Hospital, Pisa, Italy

Rossella Elisei. Department of Endocrinology, University Hospital, Pisa, Italy Rossella Elisei Department of Endocrinology, University Hospital, Pisa, Italy THYROID CANCER IS RARE TUMOR AND REPRESENTS ONLY 3.8% OF ALL HUMAN TUMORS All human cancer Thyroid cancer MOST FREQUENT CANCER

More information

Clinical Study Analysis of Clinical Outcome of Patients with Poorly Differentiated Thyroid Carcinoma

Clinical Study Analysis of Clinical Outcome of Patients with Poorly Differentiated Thyroid Carcinoma International Scholarly Research Network ISRN Endocrinology Volume 2011, Article ID 308029, 5 pages doi:10.5402/2011/308029 Clinical Study Analysis of Clinical Outcome of Patients with Poorly Differentiated

More information

Evening Specialty Conference: Cytopathology

Evening Specialty Conference: Cytopathology : Cytopathology N. Paul Ohori, M.D. University of Pittsburgh Medical Center Disclosure of Relevant Financial Relationships Disclosure of Relevant Financial Relationships USCAP requires that all planners

More information

Locally advanced papillary thyroid cancer

Locally advanced papillary thyroid cancer Locally advanced papillary thyroid cancer Educational Session 12 th October 2015 Presenters: Smith JA, Carr-Boyd E Supervisors: Palme CE, Elliott M, Navin N, Gupta R Content Case report Imaging Primary

More information

Thyroid Cancer. With 51 Figures and 30 Tables. Springer

Thyroid Cancer. With 51 Figures and 30 Tables. Springer H.-J. Biersack F. Griinwald (Eds.) Thyroid Cancer With 51 Figures and 30 Tables Springer PART 1 Basics 1 The Changing Epidemiology of Thyroid Cancer 3 R. GORGES 1.1 Basic Epidemiological Problems in Thyroid

More information

DIAGNOSIS AND REPORTING OF FOLLICULAR-PATTERNED THYROID LESIONS BY FINE NEEDLE ASPIRATION

DIAGNOSIS AND REPORTING OF FOLLICULAR-PATTERNED THYROID LESIONS BY FINE NEEDLE ASPIRATION Follicular-patterned thyroid lesions, WC Faquin 1 DIAGNOSIS AND REPORTING OF FOLLICULAR-PATTERNED THYROID LESIONS BY FINE NEEDLE ASPIRATION William C. Faquin, M.D., Ph.D Department of Pathology, Massachusetts

More information

Dr Catherine Woolnough, Hospital Scientist, Chemical Pathology, Royal Prince Alfred Hospital. NSW Health Pathology University of Sydney

Dr Catherine Woolnough, Hospital Scientist, Chemical Pathology, Royal Prince Alfred Hospital. NSW Health Pathology University of Sydney Dr Catherine Woolnough, Hospital Scientist, Chemical Pathology, Royal Prince Alfred Hospital NSW Health Pathology University of Sydney Thyroid Cancer TC incidence rates in NSW Several subtypes - Papillary

More information

ACCME/Disclosures. Cribriform Lesions of the Prostate. Case

ACCME/Disclosures. Cribriform Lesions of the Prostate. Case Cribriform Lesions of the Prostate Ming Zhou, MD, PhD Departments of Pathology and Urology New York University Langone Medical Center New York, NY Ming.Zhou@NYUMC.ORG ACCME/Disclosures The USCAP requires

More information

P apillary thyroid carcinoma (PTC) is a major histological

P apillary thyroid carcinoma (PTC) is a major histological 1041 ORIGINAL ARTICLE Papillary carcinoma of the thyroid in Japan: subclassification of common type and identification of low risk group K Kakudo, W Tang, Y Ito, I Mori, Y Nakamura, A Miyauchi... See end

More information

Persistent & Recurrent Differentiated Thyroid Cancer

Persistent & Recurrent Differentiated Thyroid Cancer Persistent & Recurrent Differentiated Thyroid Cancer Electron Kebebew University of California, San Francisco Department of Surgery Objectives Risk factors for persistent & recurrent disease Causes of

More information

Did President Grant die from too much Oral Sex?

Did President Grant die from too much Oral Sex? Case 6 Did President Grant die from too much Oral Sex? Lester D. R. Thompson www.lester-thompson.com 53 year old man Small nodule noted 2 months ago, just below the angle of the jaw during shaving Non-tender

More information

Neoplasia 2018 Lecture 2. Dr Heyam Awad MD, FRCPath

Neoplasia 2018 Lecture 2. Dr Heyam Awad MD, FRCPath Neoplasia 2018 Lecture 2 Dr Heyam Awad MD, FRCPath ILOS 1. List the differences between benign and malignant tumors. 2. Recognize the histological features of malignancy. 3. Define dysplasia and understand

More information