anatomia patologica - tiroides
TRANSCRIPT
PATOLOGIA DE LA GLANDULA TIROIDES
Xavier Matias-GuiuHospital Universitari Arnau
de Vilanova, Lleida
• Inflamaciones• Hiperplasias (Bocios)• Tumores Benignos• Tumores Malignos
Patología del Tiroides
• Inflamaciones no específicas• Granulomatosa (Quervain)• Linfocítica (Hashimoto)• Fibrosa (Riedel)
Inflamaciones del Tiroides
• Hiperplasia (Bocio) Nodular • Hiperplasia (Bocio) Difusa
(Graves – Basedow)
Hiperplasias de Tiroides
Tumors de Tiroide (tipus històlogics)
• Adenoma fol.licular• Tumor (adenoma) trabecular
hialinitzant
Cancer de Tiroide (tipus històlogic)
• Carcinoma papil·lar• Carcinoma fol·licular• Carcinoma pobrement diferenciat• Carcinoma indiferenciat (anaplàsic)• Carcinoma medul·lar
Papillary Carcinoma(Definition)
A malignant epithelial tumour showing evidence of follicular cell differentiation and characterized by distinctive nuclear features
Carcinoma Papilar de Tiroides
• Cualquier edad• Poco agresivo• El más frecuente (especuialmente en
zonas no bociógenas• Diseminación por vía linfática
Carcinoma Papilar de Tiroides(Pronóstico)
• Edad• Tamaño• Invasión extratiroidea• Metástasis a distancia
Papillary Carcinoma(variants)
• Follicular variant• Macrofollicular variant• Oncocytic variant• Clear cell variant• Diffuse sclerosing variant• Tall cell variant• Columnar cell variant
Papillary Carcinoma(size variation)
• The term Microcarcinoma should be used for a papillary carcinoma , which is incidentally found, and measures 1 cm or less.
Papillary Carcinoma(Genetics)
• RET/PTC• TRK• RAS• BRAF
Papillary Carcinoma(Genetics)
• RET/PTC1 60-70%• RET/PTC2 < 10%• RET/PTC3-4 20-30%• RET/PTC5 rare• RET/PTC6 rare• RET/PTC7 rare• RET/ELKS rare• RET/KTN1 rare• RET/RFG8 rare• RET/PCM-1 rare
Follicular Carcinoma(Definition)
A malignant epithelial tumour showing evidence of follicular cell differentiation, lacking the diagnostic nuclear features of papillary carcinoma
Follicular Carcinoma(variants)
• Oncocytic variant (Hürthle cell Tumors)• Clear cell variant
Poorly differentiated Carcinoma(Definition)
Follicular-cell neoplasms that show limited evidence of structural follicular cell differentiation and occupy both morphologically and behaviourally an intermediate position between the well differentiated follicular and papillary carcinomas and the undifferentiated carcinomas
Poorly differentiated Carcinoma(Histopathology)
• Three patterns (insular, trabecular, solid)• Infiltrative pattern of growth, necrosis and
obvious vascular invasion• Prognostic significance of minor component
is unknown
Undifferentiated (Anaplastic) Carcinoma(Definition)
Highly malignant tumours that by standard light microscopy appear wholly or partially composed of undifferentiated cells that exhibit immunohistochemical or ultrastructural features indicating epithelial differentiation
Medullary Thyroid Carcinoma(Definition)
A malignant tumour of the thyroid gland showing C-cell differentiation and lacking follicular differentiation.
ESPORADICO
MEN 2A MEN 2 B
ASOCIADO NO ASOCIADO
FAMILIAR
CARCINOMA MEDULAR DE TIROIDES
CMT ESPORÁDICO CMT FAMILIAR
Medullary Thyroid Carcinoma
RET
RETT
CMT ESPORÁDICO CMT FAMILIAR
Limfoma de Tiroide
Metastatic Tumors