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| __NOTOC__
| | [[Syncope]] is classified into three types: |
| | | * [[Cardiac]] |
| | | * [[Neurogenic]] |
| {| border="3"
| | * [[Vasovagal syncope|vasovagal]] |
| |+
| |
| ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Disease name}}
| |
| ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Age of onset}}
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| ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Gender preponderance}}
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| ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Signs/Symptoms}}
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| ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Imaging Feature(s)}}
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| ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Macroscopic feature(s)}}
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| ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Microscopic feature(s)}}
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| ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Laboratory Feature(s)}}
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| ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Other Feature(s)}}
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| ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Microscopic appearance}}
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| |-
| |
| ! style="padding: 5px 5px; background: #DCDCDC; " align="left" |Papillary Thyroid Cancer<ref name="FaginMitsiades2008">{{cite journal|last1=Fagin|first1=James A.|last2=Mitsiades|first2=Nicholas|title=Molecular pathology of thyroid cancer: diagnostic and clinical implications|journal=Best Practice & Research Clinical Endocrinology & Metabolism|volume=22|issue=6|year=2008|pages=955–969|issn=1521690X|doi=10.1016/j.beem.2008.09.017}}</ref><ref name="Schlumberger1998">{{cite journal|last1=Schlumberger|first1=Martin Jean|title=Papillary and Follicular Thyroid Carcinoma|journal=New England Journal of Medicine|volume=338|issue=5|year=1998|pages=297–306|issn=0028-4793|doi=10.1056/NEJM199801293380506}}</ref><ref name="pmid20001718">{{cite journal |vauthors=Sipos JA |title=Advances in ultrasound for the diagnosis and management of thyroid cancer |journal=Thyroid |volume=19 |issue=12 |pages=1363–72 |date=December 2009 |pmid=20001718 |doi=10.1089/thy.2009.1608 |url=}}</ref>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * More common in middle aged (30-50 years of age)
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * More commonly affects women
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| *[[Asymptomatic]] [[thyroid]] [[mass]] or [[nodule]]
| |
| *Compressive [[symptoms]] such as:
| |
| *[[Dysphagia|Difficulty swallowing]]/[[Dyspnea|breathing]]
| |
| *Persistent [[cough]]
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| *[[Stridor]]
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| *Vocal chord [[paralysis]]
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| *Rapid enlarging [[mass]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| *[[Ultrasound]]: solitary [[mass]] with an irregular outline, in the subcapsular region and with high [[vascularity]]
| |
| *[[Imaging]] features are not characteristic for this [[cancer]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Solitary hypoechogenic [[nodule]] with lobulated margin which may extend into adjacent [[tissues]]
| |
| *[[Calcification]] may be present or not
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Empty-appearing [[nuclei]] with central clearing (Orphan Annie eye)
| |
| *[[Psammoma body|Psammoma bodies]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| *[[Thyroid function test]] may be normal
| |
| *[[Thyroglobulin]] may be used as a [[tumor marker]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * History of [[radiation]] in head and neck
| |
| *[[BRAF]] and/or [[RET gene|RET]] [[mutation]] may be present
| |
| *Most common type of [[thyroid cancer]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Image:Thyroid papillary carcinoma histopathology (3).jpg|thumb|none|200px|Source:Wikimedia commons ]]
| |
| |-
| |
| ! style="padding: 5px 5px; background: #DCDCDC; " align="left" |Follicular Thyroid Cancer<ref name="Schlumberger1998">{{cite journal|last1=Schlumberger|first1=Martin Jean|title=Papillary and Follicular Thyroid Carcinoma|journal=New England Journal of Medicine|volume=338|issue=5|year=1998|pages=297–306|issn=0028-4793|doi=10.1056/NEJM199801293380506}}</ref><ref name="pmid20001718">{{cite journal |vauthors=Sipos JA |title=Advances in ultrasound for the diagnosis and management of thyroid cancer |journal=Thyroid |volume=19 |issue=12 |pages=1363–72 |date=December 2009 |pmid=20001718 |doi=10.1089/thy.2009.1608 |url=}}</ref>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Peak [[incidence]] is 40-60 years of age
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * More commonly affects women
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| *[[Asymptomatic]] [[thyroid]] [[mass]] or [[nodule]]
| |
| *Compressive [[symptoms]] such as:
| |
| *[[Difficulty swallowing]]/[[Dyspnea|breathing]]
| |
| *Persistent [[cough]]
| |
| *[[Stridor]]
| |
| *Vocal chord [[paralysis]]
| |
| *Rapid enlarging [[mass]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Ultrasound]]: solid hypoechoic [[nodule]] with a peripheral halo indicating [[fibrous capsule]]
| |
| * Irregular margin
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| * [[Imaging]] features are not characteristic for this [[cancer]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Single encapsulated [[nodule]],
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| * Thick and irregular [[capsule]]
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| * May have [[cystic]] or [[hemorrhage]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Invades [[thyroid]] [[capsule]] and [[vasculature]]
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| * Uniform [[Follicle|follicles]] <br />
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| *[[Thyroid function test]] may be normal
| |
| * Serum [[thyroglobulin]] may be used as a [[tumor marker]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| *[[RASA3|RAS]] [[mutation]] may be present
| |
| * PAX8-PPAR-γ [[Translocation|translocations]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Image:Metastatic follicular thyroid carcinoma - Case 264.jpg|thumb|none|200px|Source:Wikimedia common ]]
| |
| |-
| |
| ! style="padding: 5px 5px; background: #DCDCDC;" align="left" |Medullary Thyroid Cancer<ref name="pmid6690009">{{cite journal |vauthors=Busnardo B, Girelli ME, Simioni N, Nacamulli D, Busetto E |title=Nonparallel patterns of calcitonin and carcinoembryonic antigen levels in the follow-up of medullary thyroid carcinoma |journal=Cancer |volume=53 |issue=2 |pages=278–85 |date=January 1984 |pmid=6690009 |doi=10.1002/1097-0142(19840115)53:2<278::aid-cncr2820530216>3.0.co;2-z |url=}}</ref><ref name="pmid10699905">{{cite journal |vauthors=Kebebew E, Ituarte PH, Siperstein AE, Duh QY, Clark OH |title=Medullary thyroid carcinoma: clinical characteristics, treatment, prognostic factors, and a comparison of staging systems |journal=Cancer |volume=88 |issue=5 |pages=1139–48 |date=March 2000 |pmid=10699905 |doi=10.1002/(sici)1097-0142(20000301)88:5<1139::aid-cncr26>3.0.co;2-z |url=}}</ref><ref name="HofstraLandsvater1994">{{cite journal|last1=Hofstra|first1=Robert M. W.|last2=Landsvater|first2=Rudy M.|last3=Ceccherini|first3=Isabella|last4=Stulp|first4=Rein P.|last5=Stelwagen|first5=Tineke|last6=Luo|first6=Yin|last7=Pasini|first7=Barbara|last8=Hoppener|first8=Jo W. M.|last9=van Amstel|first9=Hans Kristian Ploos|last10=Romeo|first10=Giovanni|last11=Lips|first11=Cornells J. M.|last12=Buys|first12=Charles H. C. M.|title=A mutation in the RET proto-oncogene associated with multiple endocrine neoplasia type 2B and sporadic medullary thyroid carcinoma|journal=Nature|volume=367|issue=6461|year=1994|pages=375–376|issn=0028-0836|doi=10.1038/367375a0}}</ref><ref name="pmid20001718">{{cite journal |vauthors=Sipos JA |title=Advances in ultrasound for the diagnosis and management of thyroid cancer |journal=Thyroid |volume=19 |issue=12 |pages=1363–72 |date=December 2009 |pmid=20001718 |doi=10.1089/thy.2009.1608 |url=}}</ref>
| |
| | |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| *[[Incidence]] increases with age
| |
| * More common in 3rd to 4th decades of life
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Both genders affected equally
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Solitary [[thyroid nodule]]
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| * Mostly affects upper lobe of thyroid gland
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| * Possible [[systemic]] [[symptoms]] due to hormonal secretion by the [[tumor]]
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| *[[Cervical]] [[lymphadenopathy]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| *[[Ultrasound]]: solitary hypoechoic [[nodule]] with or without [[calcification]]
| |
| *Imaging features are not characteristic for this [[cancer]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Single nonencapsulated [[mass]]
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| * Gray-tan color
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Sheets of [[cells]] in an [[amyloid]] [[stroma]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Secretes [[calcitonin]]
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| *Normal [[thyroid function test]]
| |
| *[[Carcinoembryonic antigen]] ([[CEA]]) may be used as a [[tumor marker]]
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| *Rarely negative for [[calcitonin]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * May be part of [[MEN syndromes|MEN 2A]] and [[Multiple endocrine neoplasia type 2|2B syndrome]]
| |
| * May be associated with [[RET gene|RET]] [[mutation]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[File:Thyroid MedullaryCarcinoma SpindleCell LP PA.JPG|thumb|none|200px|Source:Wikimedia common ]]
| |
| |-
| |
| ! style="padding: 5px 5px; background: #DCDCDC;" align="left" |Anaplastic Thyroid Cancer<ref name="pmid21772843">{{cite journal |vauthors=Nagaiah G, Hossain A, Mooney CJ, Parmentier J, Remick SC |title=Anaplastic thyroid cancer: a review of epidemiology, pathogenesis, and treatment |journal=J Oncol |volume=2011 |issue= |pages=542358 |date=2011 |pmid=21772843 |pmc=3136148 |doi=10.1155/2011/542358 |url=}}</ref><ref name="pmid2794956">{{cite journal |vauthors=Chang TC, Liaw KY, Kuo SH, Chang CC, Chen FW |title=Anaplastic thyroid carcinoma: review of 24 cases, with emphasis on cytodiagnosis and leukocytosis |journal=Taiwan Yi Xue Hui Za Zhi |volume=88 |issue=6 |pages=551–6 |date=June 1989 |pmid=2794956 |doi= |url=}}</ref><ref name="pmid1695118">{{cite journal |vauthors=Venkatesh YS, Ordonez NG, Schultz PN, Hickey RC, Goepfert H, Samaan NA |title=Anaplastic carcinoma of the thyroid. A clinicopathologic study of 121 cases |journal=Cancer |volume=66 |issue=2 |pages=321–30 |date=July 1990 |pmid=1695118 |doi=10.1002/1097-0142(19900715)66:2<321::aid-cncr2820660221>3.0.co;2-a |url=}}</ref>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * More common among older individuals
| |
| *Mean age at [[diagnosis]] is 65 years
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * More commonly affects women
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Rapidly enlarging thyroid [[mass]]
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| * May manifest with compressive [[symptoms]]
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| *May present with [[signs]]/[[symptoms]] of [[metastasis]]
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| *Constitutional [[symptoms]] may be present
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| *Hard nodular [[goiter]] w/out [[tenderness]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| [[Ultrasound]]: solid hypoechoic [[nodule]] with a peripheral halo indicating [[fibrous capsule]]
| |
| * Irregular margin
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| * [[Imaging]] features are not characteristic for this [[cancer]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Solid [[tumor]] with areas of [[necrosis]] and [[hemorrhage]]
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| * Infiltrative pattern
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Undifferentiated, devastatingly aggressive variant of Papillary/[[Follicular thyroid cancer]]
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Normal [[thyroid function test]]
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Poor [[prognosis]]
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| * May be associated with [[TP53]] [[mutation]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[File:Anaplastic thyroid carcinoma low mag.jpg|thumb|none|200px|Source:Wikimedia common ]]
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| |-
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| ! style="padding: 5px 5px; background: #DCDCDC;" align="left" |Thyroid Adenoma
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * More commonly affects individuals older than 50 years of age
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * More commonly affects women
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| *[[Asymptomatic]] or [[symptoms]] of [[hyperthyroidism]]
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Solitary [[nodule]] which may show echogenicity or not
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Solitary, spherical, and encapsulated [[lesion]]
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| * Well demarcated from the surrounding [[parenchyma]]
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Uniform [[Follicle|follicles]]
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| * Absence of capsular or [[vascular]] invasion
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Functional [[adenoma]]:
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| ** Elevated T3, T4
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| ** Decreased TSH
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * May be considered functional or hot
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| * May be considered non-functional or cold
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[File:Follicular adenoma -- intermed mag.jpg|thumb|none|200px|Source:Wikimedia common ]]
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| |-
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| ! style="padding: 5px 5px; background: #DCDCDC;" align="left" |Multinodular Goiter
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Commonly affects individuals older than 60 years of age
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * More commonly affects women
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| *[[Thyroid]] enlargement
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| *[[Signs]]/[[symptoms]] of [[Hypothyroidism|hypo]]/[[hyperthyroidism]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Multiple [[nodules]] with different echogenicity
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| *[[Calcification]] may be present
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Multiple [[Thyroid nodule|thyroid nodules]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Variable sized [[Follicle|follicles]]
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| * Some may show [[papillary]] [[Projection areas|projections]] without [[nuclear]] characteristics of [[papillary thyroid cancer]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Classified as toxic and non-toxic
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| * Toxic => hyperthyroidism
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| * Non-toxic => Normal [[thyroid function test]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| *[[Benign]] [[condition]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[File:ThyroidnodularSatturwar08.jpg|thumb|none|200px|Source:pathology outline, case courtesy of Dr. Swati Satturwar]]
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| |-
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| ! style="padding: 5px 5px; background: #DCDCDC; " align="left" |Thyroid Lymphoma<ref name="pmid8838117">{{cite journal |vauthors=Pedersen RK, Pedersen NT |title=Primary non-Hodgkin's lymphoma of the thyroid gland: a population based study |journal=Histopathology |volume=28 |issue=1 |pages=25–32 |date=January 1996 |pmid=8838117 |doi= |url=}}</ref>
| |
| <ref name="pmid3141260">{{cite journal |vauthors=Hyjek E, Isaacson PG |title=Primary B cell lymphoma of the thyroid and its relationship to Hashimoto's thyroiditis |journal=Hum. Pathol. |volume=19 |issue=11 |pages=1315–26 |date=November 1988 |pmid=3141260 |doi=10.1016/s0046-8177(88)80287-9 |url=}}</ref><ref name="pmid3759532">{{cite journal |vauthors=Tupchong L, Hughes F, Harmer CL |title=Primary lymphoma of the thyroid: clinical features, prognostic factors, and results of treatment |journal=Int. J. Radiat. Oncol. Biol. Phys. |volume=12 |issue=10 |pages=1813–21 |date=October 1986 |pmid=3759532 |doi=10.1016/0360-3016(86)90324-x |url=}}</ref><ref name="pmid17042683">{{cite journal |vauthors=Ota H, Ito Y, Matsuzuka F, Kuma S, Fukata S, Morita S, Kobayashi K, Nakamura Y, Kakudo K, Amino N, Miyauchi A |title=Usefulness of ultrasonography for diagnosis of malignant lymphoma of the thyroid |journal=Thyroid |volume=16 |issue=10 |pages=983–7 |date=October 2006 |pmid=17042683 |doi=10.1089/thy.2006.16.983 |url=}}</ref>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Affects adults or elderly
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * More common among women | |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Rapidly enlarging [[mass]]/ [[nodule]] of [[thyroid]]
| |
| * Compression [[symptoms]] may be present | |
| * [[B symptoms|Constitiutional symptoms]] may be present in 10% | |
| * P/E:Firm, hard [[thyroid]]
| |
| * Fixed to the nearby structure
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| * Immobile even during swallowing
| |
| * [[Cervical]] or [[supraclavicular]] [[lymphadenopathy]] may be present
| |
| | |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Ultrasound]]: hypoechogenic appearance difficult to be distinguished from chronic [[thyroiditis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Thyroid nodule]]/[[mass]] fixing to adjacent [[tissue]] with a firm texture
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * It is of [[B cell]] lineage in the majority of cases
| |
| * Dffuse, large [[B-cell lymphoma|B-cell lymphomas]] is the most common subtype: diffuse infiltrate of B cells destroying thyroid follicles
| |
| * [[Marginal zone lymphoma]] is the second most common type
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * No specific test
| |
| * Some may have [[hypothyroidism]]
| |
| * Some may have [[antibody]] against [[thyroid peroxidase]] or [[thyroglobulin]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Preexisting chronic [[Hashimoto's thyroiditis|autoimmune (Hashimoto's) thyroiditis]] is a known [[risk factor]] for this [[condition]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[File:Thyroid lymphoma large cell type fine needle aspiration biop.jpeg|thumb|none|200px|Source:pathology outline, case courtesy of Dr. Mark R. Wick]]
| |
| |}
| |
| <references />
| |