TUMORS OF THE THYROID GLAND

by

JUAN ROSAI, M.D.
Department of Pathology
Memorial Sloan-Kettering Cancer Center
New York, New York 10021

MARIA LUISA CARCANGIU, M.D.
Department of Pathology
Yale University School of Medicine
New Haven, Connecticut 06510

and

RONALD A. DELELLIS, M.D.
Department of Pathology
Tufts University School of Medicine
and the New England Medical Center
Boston, Massachusetts 02111


Table of Contents

1. Introduction
2. The Normal Thyroid Gland
   2.1 Embryology
   2.2 Anatomy
   2.3 Histology
     2.3.1 Architectural Features
     2.3.2 The Follicular Cell
     2.3.3 The C Cell
     2.3.4 Solid Cell Nests
   2.4 Physiology
     2.4.1 Thyroid Hormones
     2.4.2 Calcitonin and the Calcitonin Gene-Related Peptide
3. Classification of Thyroid Tumors
4. Follicular Adenoma
  4.1 Adenoma Variants
     4.1.1 Adenoma with Bizarre Nuclei
     4.1.2 Hyalinizing Trabecular Adenoma
     4.1.3 Adenolipoma and Adenochondroma
     4.1.4 Atypical Adenoma
     4.1.5 Adenoma with Papillary Hyperplasia
     4.1.6 "Toxic" Adenoma
5. Follicular Carcinoma
   5.1 Minimally Invasive (Encapsulated) Type
   5.2 Widely Invasive Type
6. Papillary Carcinoma
   6.1 Papillary Carcinoma Variants
      6.1.1 Papillary Microcarcinoma
      6.1.2 Encapsulated Variant
      6.1.3 Follicular Variant
      6.1.4 Encapsulated Follicular Variant and Related Lesions
      6.1.5 Solid/Trabecular Variant
      6.1.6 Diffuse Sclerosing Variant
      6.1.7 Tall and Columnar Cell Variants
7. Poorly Differentiated Carcinoma
   7.1 Insular Carcinoma
   7.2 Other Poorly Differentiated Carcinomas
8. Undifferentiated (Anaplastic) Carcinoma
9. Tumors with Oncocytic Features (Hürthle Cell Tumors)
   9.1 Oncocytic Adenoma (Hürthle Cell Adenoma)
   9.2 Oncocytic Carcinoma (Hürthle Cell Carcinoma)
   9.3 Papillary Oncocytic Neoplasms
10. Tumors with Clear Cell Features
11. Tumors with Squamous Features
12. Tumors with Mucinous Features
13. Medullary Carcinoma
   13.1 Medullary Carcinoma Variants
      13.1.1 Tubular (Follicular) Variant
      13.1.2 Papillary Variant
      13.1.3 Small Cell Variant
      13.1.4 Giant Cell Variant
      13.1.5 Clear Cell Variant
      13.1.6 Melanotic (Pigmented) Variant
      13.1.7 Oncocytic (Oxyphilic) Variant
      13.1.8 Squamous Variant
      13.1.9 Amphicrine (Composite Calcitonin and Mucin-Producing)
             Variant
      13.1.10 Paraganglioma-Like Variant
      13.1.11 Encapsulated Medullary Carcinoma
   13.2 Mixed Medullary-Follicular Carcinoma
   13.3 Mixed Medullary-Papillary Carcinoma
14. C Cell Hyperplasia
15. Sarcomas
   15.1 Angiosarcoma
16. Malignant Lymphoma
   16.1 Other Lymphoid Tumors
      16.1.1 Plasmacytoma
      16.1.2 Hodgkin Disease
17. Miscellaneous Tumors
   17.1 Parathyroid Tumors
   17.2 Paraganglioma
   17.3 Teratoma
   17.4 Benign Soft Tissue-Type Tumors
   17.5 Tumors with Thymic or Related Branchial Pouch Differentiation
      17.5.1 Ectopic Cervical Thymoma
      17.5.2 Ectopic Hamartomatous Thymoma
      17.5.3 Spindle Epithelial Tumor with Thymus-Like Differentiation
             (SETTLE)
      17.5.4 Carcinoma Showing Thymus-Like Differentiation (CASTLE)
   17.6 Salivary Gland-Type Tumors
18. Secondary Tumors
19. Tumor-Like Conditions
   19.1 Nodular Hyperplasia
   19.2 Diffuse Hyperplasia
   19.3 Dyshormonogenetic Goiter
   19.4 Hashimoto Thyroiditis
   19.5 Other Forms of Thyroiditis
   19.6 Malakoplakia
   19.7 Radiation Changes
   19.8 Amyloid Goiter
   19.9 Histiocytosis X
   19.10 Sinus Histiocytosis with Massive Lymphadenopathy
   19.11 Plasma Cell Granuloma
20. Thyroid Tissue in Abnormal Locations
   20.1 Ectopia
   20.2 Mechanical Implantation
   20.3 Parasitic Nodule
   20.4 Thyroid Inclusions in Lymph Nodes
   20.5 Thyroid as a Component of Teratoma
21. Thyroid Tumors-General Considerations
   21.1 Incidence of Thyroid Carcinoma
   21.2 Clinical and Laboratory Evaluation of Thyroid Tumors
   21.3 Thyroid Tumors in Childhood
   21.4 Thyroid Tumors and Radiation Exposure
   21.5 Fine-Needle Aspiration Biopsy
   21.6 Frozen-Section Examination
   21.7 Procedure for Pathologic Examination
   21.8 Staging and Grading of Thyroid Carcinoma
   21.9 Treatment of Thyroid Tumors
   21.10 Prognosis of Thyroid Tumors
   21.11 Thyroid Tumors in Animals
22. Index

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