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| __NOTOC__
| | [[Syncope]] is classified into three types: |
| {| class="wikitable sortable mw-collapsible"
| | * [[Cardiac]] |
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| | * [[Neurogenic]] |
| | | * [[Vasovagal syncope|vasovagal]] |
| ! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" + |Paraneoplastic Syndrome
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| | align="center" style="background:#4479BA; color: #FFFFFF;" |'''Type of paraneoplastic syndrome'''
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| | align="center" style="background:#4479BA; color: #FFFFFF;" |'''Subtype'''
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| | align="center" style="background:#4479BA; color: #FFFFFF;" |'''Associated Cancers'''
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| | rowspan="5" align="center" style="background:#f0f0f0;" |[[Endocrine|Endocrine metabolic]] [[Syndrome|syndromes]]
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| |[[Hypercalcemia]]
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| |[[breast cancer]] and [[lung cancer]] (typically [[Squamous cell carcinoma|squamous cell]]) due to the production of [[Parathyroid hormone-related protein|PTHrP]] ([[Parathyroid hormone]]-related [[protein]])[[multiple myeloma]], [[renal cell carcinoma]], [[ovarian cancer]], [[endometrial cancer]], and [[lymphoma]]
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| *
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| |[[Syndrome of inappropriate antidiuretic hormone|SIADH]]||[[small cell lung cancer]], [[mesothelioma]], [[breast]], [[prostate]], [[adrenal]], [[urethral]], [[thymoma]], [[lymphoma]], GI, CNS, and [[Ewing sarcoma]]
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| *
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| |[[Ectopic]] [[ACTH]] [[secretion]]||[[Small cell lung cancer|small-cell lung cancer]], [[carcinoid tumor]], [[thymoma]] and other [[Cancer|cancers]]
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| |[[Tumor induced osteomalacia]]
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| *
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| |[[Hypoglycemia]]
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| |[[Gastrointestinal tract|GI]] cancers, [[mesothelioma]], [[lung]], and [[sarcomas]]
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| | rowspan="6" align="center" style="background:#f0f0f0;" |[[Mucocutaneous|Musculocutaneous]] paraneoplastic syndromes
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| |[[Dermatomyositis]]
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| *
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| |[[Leser-Trelat sign|Leser-Trélat sign]]
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| |gastrointestinal adenocarcinomas (gastric, colon, rectal), breast cancer, and lymphoproliferative disorders/lymphoma, and melanoma.
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| |[[Acanthosis nigricans]]
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| |gastric adenocarcinoma, endometrial cancer, and etc.
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| |[[Necrolytic migratory erythema]]||
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| |[[Sweet's syndrome]]||
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| *
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| |[[Pyoderma gangrenosum]]
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| | rowspan="11" align="center" style="background:#f0f0f0;" |[[Neurological]] paraneoplastic syndromes:
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| |[[Paraneoplastic cerebellar degeneration]]
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| *
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| |[[Encephalomyelitis]]
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| *
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| |[[Limbic encephalitis]]
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| *
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| |[[Encephalitis|Brainstem encephalitis]]
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| |[[Opsoclonus]] (involving eye movement)||
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| *
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| |[[Encephalitis]]||[[teratoma]]
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| |[[Polymyositis]]
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| |[[Autonomic neuropathy]]
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| |[[Lambert-Eaton myasthenic syndrome]] ([[LEMS]])
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| |[[Small cell lung cancer|small-cell lung cancer]]
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| |[[Myasthenia gravis]]
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| |Subacute (peripheral) [[sensory neuropathy]]
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| | rowspan="4" align="center" style="background:#f0f0f0;" |[[Hematological]] paraneoplastic syndromes
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| |[[Granulocytosis]]
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| |[[Thrombocytosis]]
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| |[[Pure red cell aplasia]]
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| |[[Eosinophilia]]
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| | align="center" style="background:#f0f0f0;" |Others
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| |[[Membranous glomerulonephritis]]
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| |}
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| {| border="3"
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| ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Disease name}}
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| ! 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
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * More common in middle aged (30-50 years of age)
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * More commonly affects women
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| *[[Asymptomatic]] [[thyroid]] [[mass]] or [[nodule]]
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| *Compressive [[symptoms]] such as:
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| *[[Dysphagia|Difficulty swallowing]]/[[Dyspnea|breathing]]
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| *Persistent [[cough]]
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| *[[Stridor]]
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| *Vocal chord [[paralysis]]
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| *Rapid enlarging [[mass]]
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| *[[Ultrasound]]: solitary [[mass]] with an irregular outline, in the subcapsular region and with high [[vascularity]]
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| *[[Imaging]] features are not characteristic for this [[cancer]]
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Solitary hypoechogenic [[nodule]] with lobulated margin which may extend into adjacent [[tissues]]
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| *[[Calcification]] may be present or not
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Empty-appearing [[nuclei]] with central clearing (Orphan Annie eye)
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| *[[Psammoma body|Psammoma bodies]]
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| *[[Thyroid function test]] may be normal
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| *[[Thyroglobulin]] may be used as a [[tumor marker]]
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * History of [[radiation]] in head and neck
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| *[[BRAF]] and/or [[RET gene|RET]] [[mutation]] may be present
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| *Most common type of [[thyroid cancer]]
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Image:Thyroid papillary carcinoma histopathology (3).jpg|thumb|none|200px|Source:Wikimedia commons ]]
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| ! style="padding: 5px 5px; background: #DCDCDC; " align="left" |Follicular Thyroid Cancer
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Peak [[incidence]] is 40-60 years of age | |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * More commonly affects women
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| *[[Asymptomatic]] [[thyroid]] [[mass]] or [[nodule]] | |
| *Compressive [[symptoms]] such as: | |
| *[[Difficulty swallowing]]/[[Dyspnea|breathing]]
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| *Persistent [[cough]]
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| *[[Stridor]]
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| *Vocal chord [[paralysis]]
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| *Rapid enlarging [[mass]]
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * [[Ultrasound]]: solid hypoechoic [[nodule]] with a peripheral halo indicating [[fibrous capsule]]
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| * Irregular margin
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| * [[Imaging]] features are not characteristic for this [[cancer]]
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Single encapsulated [[nodule]],
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| * Thick and irregular [[capsule]]
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| * May have [[cystic]] or [[hemorrhage]]
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Invades [[thyroid]] [[capsule]] and [[vasculature]]
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| * Uniform [[Follicle|follicles]] <br />
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| *[[Thyroid function test]] may be normal
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| * Serum [[thyroglobulin]] may be used as a [[tumor marker]]
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| *[[RASA3|RAS]] [[mutation]] may be present
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| * PAX8-PPAR-γ [[Translocation|translocations]]
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Image:Metastatic follicular thyroid carcinoma - Case 264.jpg|thumb|none|200px|Source:Wikimedia common ]]
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| ! style="padding: 5px 5px; background: #DCDCDC;" align="left" |Medullary Thyroid Cancer
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| *[[Incidence]] increases with age
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| * More common in 3rd to 4th decades of life
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Both genders affected equally
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * 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]]
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| *[[Ultrasound]]: solitary hypoechoic [[nodule]] with or without [[calcification]]
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| *Imaging features are not characteristic for this [[cancer]]
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Single nonencapsulated [[mass]]
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| * Gray-tan color
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Sheets of [[cells]] in an [[amyloid]] [[stroma]]
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Secretes [[calcitonin]]
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| *Normal [[thyroid function test]]
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| *[[Carcinoembryonic antigen]] ([[CEA]]) may be used as a [[tumor marker]]
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| *Rarely negative for [[calcitonin]]
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * May be part of [[MEN syndromes|MEN 2A]] and [[Multiple endocrine neoplasia type 2|2B syndrome]]
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| * May be associated with [[RET gene|RET]] [[mutation]]
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[File:Thyroid MedullaryCarcinoma SpindleCell LP PA.JPG|thumb|none|200px|Source:Wikimedia common ]]
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| ! style="padding: 5px 5px; background: #DCDCDC;" align="left" |Anaplastic Thyroid Cancer
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * More common among older individuals
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| *Mean age at [[diagnosis]] is 65 years
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * More commonly affects women
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * 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]]
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| [[Ultrasound]]: solid hypoechoic [[nodule]] with a peripheral halo indicating [[fibrous capsule]]
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| * Irregular margin
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| * [[Imaging]] features are not characteristic for this [[cancer]]
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * 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]]
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| | 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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| ! style="padding: 5px 5px; background: #DCDCDC;" align="left" |Follicular Adenoma
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| | 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" |
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| * More commonly affects women
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| *[[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" |
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| * Uniform [[Follicle|follicles]]
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| * Absence of capsular or [[vascular]] invasion
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * 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" |
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| * 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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| ! style="padding: 5px 5px; background: #DCDCDC;" align="left" |Multinodular Goiter
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Commonly affects individuals older than 60 years of age
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * More commonly affects women
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| *[[Thyroid]] enlargement
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| *[[Signs]]/[[symptoms]] of [[Hypothyroidism|hypo]]/[[hyperthyroidism]]
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Multiple [[nodules]] with different echogenicity
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| *[[Calcification]] may be present
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Multiple [[Thyroid nodule|thyroid nodules]]
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Variable sized [[Follicle|follicles]]
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| * Some may show [[papillary]] [[Projection areas|projections]] without [[nuclear]] characteristics of [[papillary thyroid cancer]]
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| | 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]]
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| *[[Benign]] [[condition]]
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| | 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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| ! style="padding: 5px 5px; background: #DCDCDC; " align="left" |Thyroid Lymphoma
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| | |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Affects adults or elderly
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * More common among women
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Rapidly enlarging [[mass]]/ [[nodule]] of [[thyroid]]
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| * Compression [[symptoms]] may be present
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| * [[B symptoms|Constitiutional symptoms]] may be present in 10%
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| * P/E:Firm, hard [[thyroid]]
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| * Fixed to the nearby structure
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| * Immobile even during swallowing
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| * [[Cervical]] or [[supraclavicular]] [[lymphadenopathy]] may be present
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| | |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * [[Ultrasound]]: hypoechogenic appearance difficult to be distinguished from chronic [[thyroiditis]]
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * [[Thyroid nodule]]/[[mass]] fixing to adjacent [[tissue]] with a firm texture
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * It is of [[B cell]] lineage in the majority of cases
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| * Dffuse, large [[B-cell lymphoma|B-cell lymphomas]] is the most common subtype: diffuse infiltrate of B cells destroying thyroid follicles
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| * [[Marginal zone lymphoma]] is the second most common type
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * No specific test
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| * Some may have [[hypothyroidism]]
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| * Some may have [[antibody]] against [[thyroid peroxidase]] or [[thyroglobulin]]
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Preexisting chronic [[Hashimoto's thyroiditis|autoimmune (Hashimoto's) thyroiditis]] is a known [[risk factor]] for this [[condition]]
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| | 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]]
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| |}
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| <references />
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