Pathology of Tumors of the Thyroid Gland

Ronald H. Nishiyama, MD

Tumors of the thyroid gland can be problems for endocrinologists, surgeons, and pathologists. Carcinomas of the thyroid gland range from the innocuous occult papillary carcinoma to the extremely lethal anaplastic form. Approximately 12,000 new cases of thyroid cancers are discovered each year in the United States; however, fewer than 1% of deaths caused by cancers are due to thyroid cancers.1 Because only 9% of patients affected by the disease die from it, malignant tumors of the thyroid gland are not a significant public health problem.

The treatment of carcinoma of the thyroid gland continues to engender controversy. The extent of thyroidectomy in the treatment of papillary and follicular carcinomas is controversial. The role of radioactive iodine in the postoperative treatment of patients is still debated, and histologic criteria for the pathologic diagnoses of certain thyroid tumors are uncertain.

This chapter concentrates on the epithelial tumors of the thyroid gland. The discussion centers on the pathology and cytopathology of carcinomas of the thyroid gland. Controversies involving criteria to determine histologic diagnoses and classification of thyroid tumors are described. Descriptions of nonepithelial tumors are included when appropriate. Nodular goiters, thyroiditis, hyperplastic changes in the thyroid gland, and other non-neoplastic changes are discussed in the context of the diagnosis and treatment of thyroid neoplasms.

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