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Flashcards in Lesson 1E (Part 3) Deck (40)
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1

Follicular neoplasm

Encapsulated true neoplasms of the thyroid gland
- 5-10% of all thyroid nodules

2

What is differentiation of follicular adenoma from a follicular carcinoma based on?

The presence of capsular or vascular invasion on histologic examination
- cannot be made by sonography or by FNA cytology

3

What does follicular adenomas and follicular carcinomas look like sonographically? (2)

1. Solitary encapsulated tumors
2. Well-defined peripheral hypoechoic halo representing the fibrous capsule

4

What kind of follicular neoplasms are considered minimally invasive?

The types that are encapsulated

5

What kind of follicular neoplasms are considered invasive?

Extends beyond the tumour capsule into blood vessels and adjacent parenchyma

6

What is the echogenicity of follicular neoplasms?

Variable
- echogenic
- isoechoic
- hypoechoic

7

How do echogenic adenomas appear?

1. Smoothly marginated
2. Ovoid in appearance
3. Pseudotesticle

8

Medullary thyroid cancer

Neuroendocrine tumor arising from the parafollicular C cells located in the upper two thirds of the thyroid gland

9

What is the sonographic appearance of medullary carcinoma? (3)

1. Solid
2. Hypoechoic
3. Coarse central calcifications

10

Anaplastic carcinoma

Is a rare (<1%) thyroid mass that is extremely aggressive

11

Who does anaplastic carcinoma affect?

The elderly with a history of goiter

12

How does anaplastic carcinoma present?

A rapidly growing neck mass
- tumor invades locally

13

How do anaplastic carcinomas appear sonographically? (6)

1. Large
- at least 5 to 10 cm
2. Fixed
- not going to move/slide
3. Hard
- not compressible
4. Heterogeneous
5. Internal calcifications and cystic or necrotic areas
6. Adjacent enlarged lymph nodes

14

What are most thyroid lymphomas?

Non-Hodgkin lymphomas

15

How does lymphomas present itself?

With a rapidly enlarging painless neck mass

16

What is the sonographic appearance of lymphoma? (2)

1. Very hypoechoic
2. Pseudocystic pattern
- increased through transmission

17

What is the sonographic appearance of metastatic disease? (5)

1. Nonspecific appearance
2. Usually solid
3. Noncalcified
4. Hypoechoic nodules
5. Can be hypervascular

18

Hyperparathyroidism

Excess secretion of parathyroid hormone
- usually by benign tumours of a gland

19

What does hyperparathyroidism cause?

The release of calcium from bones which raised the blood calcium levels
- hypercalcaemia

20

What are 5 effects of hyperparathyroidism?

1. Polyuria and polydipsia
2. Formation of renal calculi
3. Anorexia and constipation
4. Muscle weakness
5. General fatigue

21

What are the 2 types of hyperparathyroidism?

1. Primary
2. Secondary

22

Primary hyperparathyroidism

An enlargement of one or more of the parathyroid glands causes overproduction of the hormone, resulting in high levels of calcium in the blood
- hypercalcemia

23

What is primary hyperparathyroidism caused by?

A single adenoma
- 85% of cases

24

Primary

Is involved with the organ or system itself that is causing problems

25

Secondary hyperparathyroidism

Occurs as a result of another disease that initially causes low levels of calcium in the body and over time, increased parathyroid hormone levels occur

26

Secondary

Is involved with something outside the organ or system itself that is causing problems

27

Tertiary hyperparathyroidism

Is a state of excessive secretion of parathyroid hormone after longstanding secondary hyperparathyroidism and resulting in hypercalcemia

28

When does tertiary hyperparathyroidism persist?

After successful renal transplantation

29

What are causes of hyperthyroidism? (6)

1. Medical conditions that cause low blood calcium levels or increased phosphate levels
2. Conditions that make it hard for the body to remove phosphate
3. Kidney failure
4. Not enough calcium in the diet
5. Vitamin D disorders
6. Problems absorbing nutrients from food

30

What is the result of hyperparathyroidism? (4)

1. Increased risk of bone fractures
2. High blood pressure and heart disease
3. Kidney stones
4. Osteitis fibrosa