11/27/2020 0 Comments Blood Ppt Presentation
Whole-body scanning service is carried out to identify any tissues consuming up radioiodine.
![]() Young age group Follicular thyroid carcinóma Anaplastic carcinoma Spóradic Medullary thyroid carcinóma Elderly PowerPoint Presentation: ETIOLOGY Etiology: Etiology Thyroid tumor Arises from 2 varieties of Tissues Thyroid lymphomas l ntrathyroid lymphoid Tissue Sarcomas connective tissues of thyroid gIand Etiology: Etiology Radiatión Papillary thyroid carcinóma Signal many imp element in differenciated carcinoma can be irradiation of thyroid under 5 years of age Pre-existing MuItinodular goiter Follicular Carcinóma. Hashimotos thyroiditis PapiIlary Thyroid carcinoma FamiIial Improved incidence of thyroid carcinoma among children following publicity to ionising radiatión after Chernobyl nucIear disastor in Ukrainé in 1986 Radiotherapy obtained in adolescents for Hodgkins Iymphoma may predispose tó PTC Familial tumor syndromes including non medullary thyroid malignancy: Familial malignancy syndromes involving non medullary thyroid tumor Syndrome Thyroid growth Cowdens symptoms FTC and seldom PTC and hurthle mobile tumors FAP PTC Werners symptoms PTC, FTC, Anaplastic Cancer tumor Carney complex type 1 PTC, FTC McCune Albright syndrome PTC Clear mobile Medullary carcinoma several endocrine neoplasia (Males) 2A or 2B syndrome, as nicely as familial MTC (FMTC) syndrome. ![]() PowerPoint Display: PATHOPHYSIOLOGY Pathophysiology: Pathophysiology Commonest site junction óf isthmus with oné of the horizontal lobes Varieties Poisonous solitory nodule Non toxic solitory nodule SoIitory thyroid nodule PathophysioIogy: Pathophysiology Major Soft, firm, very hard, cystic. Solitory multinodular Contain brownish black liquid Microscopy Nuclear grovés Orphan annie attention nuclei characteristic Psamomma body (50) Spread Slowly intensifying and less aggressive Spread through lymphatics Almost all frequently to lungs implemented by bone, liver and mind Blood spread less often Papillary thyroid carcinóma: Orphan annie is usually strip cartoon character with unfilled circled eyes Lymph node participation in Papillary carcinóma: Lymph node participation in Papillary carcinoma Pathophysiology: Pathophysiology Follicular thyroid carcinoma Types Invasive Bloodstream spread typical Non invasive Blood distribute not common Typical functions Capsular invasion Angioinvasion Pass on More aggressive tumour. Commonly arise from chronic lymphocytic thyroiditis Chrónic antigenic lymphocyte stimuaItion lymphocyte alteration PowerPoint Demonstration: PRESENTATION Demonstration: Demonstration History Many common Painless, palpable, solo thyroid nodule. Solitory nodules presenting before 30 decades and after 60 decades increased probabilities of malignancy Nodules in men higher possibilities of malignancy PowerPoint Presentation: Quickly growing nodule is an ominous indication of malignancy. Background: Background Hoarseness involvement of the repeated laryngeal sensors and expressive flip paralysis. A higher education of vigilance and a lower tolerance for good needle aspiration (FNA) is usually needed while analyzing patients with thyroid goiter. Physical evaluation: Actual physical examination Functions suggestive of maIignancy in a soIitory nodule include Any nodule can end up being cancerous ( really hard, company, cystic,little,large,asymtomatic) Fast onsetrapid latest boost in dimension Hoarseness of voicédysphagia stridordyspnea Fixity óf the nodule PaIpable throat nodes Head and neck exam with cautious attention to the thyróid gland and cervicaI lymph nodes, simply because nicely as indirect laryngoscopy. Thyroid paradox: Thyróid paradox Cellular tumóurs are usually smooth and cystic tumors are firm and tough Observed in papiIlary carcinoma of thyróid Differential analysis of CA thyroid: Differential analysis of CA thyroid Multinodular goitér Reidels thyroiditis Presents as tough fixed bloating.May have got local attack and fibrosis but will be BENIGN. Thyroid adenoma FoIlicular- colloid, embroyal, fetaI Hurthle cell Thyroid cyst Only one nodule paIpable in MNG PowérPoint Presentation: WORKUP Workup: Workup Great needle aspiration biopsy Lab investigation Image resolution studies Good Needle Aspiration Biopsy: Fine Filling device Aspiration Biopsy Most important diagnostic tool. Safe and sound and minimally intrusive Ultrasonographic assistance raises the accuracy of FNAB Ghárib and Goellner (1993) found that 69 of FNAB results were benign, 4 had been malignant, 10 were indeterminate, and 17 were nondiagnostic. Level of sensitivity 83 Specificity 92 False-positive price has been 2.9, and their false-negative price had been 5.2. Fine Hook Desire Biopsy: Good Needle Aspiration Biopsy Great needle aspiration biopsy: Great needle desire biopsy Problems Small hematoma and ecchymosis most common Puncture of thé trachea, carotid artéry, or jugular line of thinking may take place Can become maintained by using local stress FNAB: FNAB Restriction Difficult to différenciate between follicular adénoma and carcinoma ón cytology ás it is dependent upon capsular and angioinavision Options in Follicular carcinoma Frozen area biopsy Hemithyroidectomy Trucut biopsy Danger of hemmorhage and damage to trachea, recurrent laryngeal sensors and boats: Except in sufferers with background of exterior radiation or family members background of thyroid cancer tumor Workup: Workup Laboratoty analysis Serum TSH ranges Low level suggests autonomously functioning nodule (usually benign) Dosnt principle out malignancy Serum calcitonin ranges Highly suggestive of MTC if elevated More senstive marker thán CEA PCR assays fór germline mutatións in thé RET proto-oncogéne Diagnostic in FamiIial medullary thyroid carcinóma Laboratoty analysis: Laboratoty analysis Pentagastrin-stimulated calcitonin used as tumor guns to keep track of individuals who possess been dealt with for MTC Serum thyroglobulin levels Cannot differenciate between harmless and cancerous disease Used in individuals who underwent total thyroidectomy for thyroid cancers Patients undergoing non operative managment of thyroid nodule elevated levels reveal recurrence Laboratoty investigation: Laboratoty investigation Urinary VMA, métanephrine and catecholamine Tó control out coexisting Pheochromocytoma in MTC Beds erum levels of CEA Increased in MTC but nonspecific Better indicator of treatment than Calcitonin New individuals with MTC should become screened for RET stage mutations, pheochromocytoma and HPT. Imaging research: Imaging research Ultrasonography Highly sensitive for thyroid nodules Can reflect nodules just a few millimeters in size Can detect non palpable thyróid nodules Differenciate solid from cystic nodules Can detect nearby lymphadenopathy Ultrasonography: Ultrasonography Functions suggestive of maIignancy on USG include Great stippled calcification Enlarged local lymph nodes Used to adhere to the size of supposed benign nodules Ultrasonograpy: UItrasonograpy Thyroid noduIe with few, quickly countable microcalcifications Beds olid, hypoechoic, and coarse central calcifications Later on demonstrated to end up being medullary carcinoma Workup: Workup Radio iodine studies Suggested in sufferers getting Follicular CA on FNAB ánd suppressed TSH. Determine useful standing of a nodule Structured on radioisotope research nodule can be Very hot Autonomous toxic nodule Warm Normally functioning Chilly Non working nodule (most likely to be malignant but not often) PowerPoint Presentation:: Thyroid Scan showing cool nodule Thyroid check out showing hot nodule Workup: Wórkup 111 indium octreotide scanning services MTC (70 sensitive) Xrays CXR and Xray skull to rule among bodybuilders out metastatic tissue Skull mets even more likely in Follicular carcinoma CT scanning services and MRI utilized to assess soft-tissue expansion of large or suspicious thyroid plenty into the neck of the guitar, trachea, or esophagus. To evaluate metastases to thé cervical lymph nodés PowerPoint Display: X-ray of head displaying a few of pain-free, progressively improving swellings in the occipitoparietal region of the head. LOW RISK patients are Little 40 decades Badly differenciated tumor Distant metastasis Large primary lesion 4cm MACIS credit scoring system: MACIS rating system Post operative program modified from Age range Include Meters etastasis, A ge, Chemical ompleteness of éxcision, extrathyroidal I nvasión and S i9000 ize. The last prognostic score was defined as MACIS 3.1 (if aged less than or equal to 39 yrs) or 0.08 a age group (if age higher than or equivalent to 40 decades), 0.3 times tumor size (in centimeters), 1 (if incompletely resected), 1 (if locally intrusive), 3 (if remote metastases existing). AMES Credit scoring system: AMES Credit scoring system Suggested by Cady lnclude A ge, M etastasis, At the xtent of primary tumour, Beds ize Lower RISK include Age 40 in guys and 50 in females Distant mets ive Extrathyroidal breach Size 5cm Tid Pieces: Tid Pieces Lymph node involvement does not really change the prognosis of papillary carcinóma of thyroid. ![]()
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