papillary thyroid cancer
Introduction
Introduction to thyroid papillary cancer Papillary thyroid carcinoma is the most common and mildest. About half of thyroid cancer is more common in children or young (before 40 years old) female patients, and some patients have had neck x-ray treatment during childhood. The tumor grows slowly and can be confined within the thyroid gland for several years. The lesion can spread from the primary site to the other parts of the gland and local lymph nodes through the intra-glandular lymphatic vessels. It can also be confined for several years, so it is easy to ignore its nature. Pathologically, the well-differentiated columnar epithelium showed papillary processes, and the nucleus was clear with eosinophilic cytoplasm. The calcium deposits in the concentric garden were often observed. Clinically, except for sputum and nodules or local lymph nodes, there is less performance. Thyroid nuclides are cold nodules when scanned; neck X-ray examination can show that the tumor has fine spots or concentric garden calcium deposits. Papillary carcinoma can be stimulated by the stimulation of TSH, which can be reduced by thyroid hormones. Surgery, such as intact capsule without metastasis, normal life. In the case of vascular invasion, 80% of patients have a 10-year survival rate. basic knowledge The proportion of sickness: 0.01% Susceptible people: no specific population Mode of infection: non-infectious Complications: respiratory failure
Cause
Causes of thyroid papillary cancer
1, the naked eye: the tumor is generally round, about 2cm ~ 3cm in diameter, no capsule, hard texture, gray face, some cases have cyst formation, nipples can be seen inside the capsule, it is called papillary cystadenocarcinoma ), tumors are often accompanied by hemorrhage, necrosis, fibrosis and calcification.
2, under the microscope: the nipple branches more, the center of the nipple has fibrovascular interstitial (true nipple), the interstitial is usually concentric calcified bodies, namely sapmmoma bodies (psammoma bodies), which is helpful for diagnosis. The nipple epithelium can be single or multi-layered, and the cancer cells can be differentiated to different degrees, with less nuclear chromatin, often transparent or frosted glass, and no nucleoli. Papillary carcinoma sometimes occurs in microcarcinoma, which is less than 1 cm in diameter and is also called "occult carcinoma" in clinical practice. Most of them are noticed during necropsy or thyroidectomy due to other diseases or due to cervical lymph node metastasis. The thyroid microcarcinoma has a good prognosis and distant metastasis is rare.
Prevention
Thyroid papillary cancer prevention
1. Try to avoid X-rays of head and neck in childhood.
2. Maintaining a happy spirit and preventing emotional internal injuries is an important aspect of preventing the occurrence of this disease.
3. For water and soil factors, pay attention to diet adjustment, and often eat kelp, in fact, it may also be another predisposing factor for certain types of thyroid cancer.
4. Patients with thyroid cancer should eat nutritious food and fresh vegetables to avoid fatty.
5. Avoid the use of estrogen, because it plays a role in the development of thyroid cancer.
6. For thyroid proliferative diseases and benign tumors should go to the hospital for positive.
7. Postoperative thyroid cancer, active use of Chinese and Western medicine prevention and treatment is an effective way to improve the efficacy.
8. Actively exercise and improve disease resistance.
Complication
Thyroid papillary cancer complications Complications, respiratory failure
The tumor rapidly enlarges, compresses the trachea, infiltrates the esophagus and recurrent laryngeal nerve and causes difficulty in breathing.
Symptom
Thyroid papillary cancer symptoms common symptoms goiter hardening
feature:
The histopathological types of thyroid cancer include papillary carcinoma, follicular carcinoma, medullary carcinoma, and undifferentiated carcinoma. Among them, papillary carcinoma has some unique pathological and biological behavioral features: (1) all or Almost all of the follicular structure without a papillary structure, but as long as the cancer cell nucleus presents a characteristic change in papillary carcinoma, the diagnosis of papillary carcinoma rather than follicular carcinoma; (2) thyroid follicular adenoma but no papillary gland Tumor, that is, when the milky structure appears, can diagnose cancer, if not cancer, and no papillary adenoma, then diagnose what and how to identify, (3) the diagnosis of papillary carcinoma is not like follicular cancer, looking for blood vessels Invasion of the capsule, as long as the characteristics of the cancer cell nucleus, no matter how small the lesion is limited to the inside of the capsule or small to the microscope can be diagnosed, then how to master these characteristic nuclear changes and many other histopathological diagnosis The points are sometimes not very clear and it is necessary to summarize and analyze them.
Among the four types of thyroid cancer, medullary carcinoma and undifferentiated carcinoma are generally not easily confused, and after grasping the diagnostic features of papillary carcinoma, the rest is follicular cancer. Therefore, it is very important to master the histopathological points of papillary carcinoma.
Histopathological points of papillary carcinoma:
Tissue structure: (1) invasive growth; (2) interstitial hardening; (3) multi-branched slender nipple; (4) often with follicles, oblate, when the nipple structure is reduced, the follicle contains deep-stained colloid; (5) The appearance of sand granules is a characteristic marker of papillary carcinoma. Sometimes only the granules are not seen in the granules, but the nipple structure is found when multiple sections are taken. Attention should be paid to the identification of calcified gelatin, the grit is located in the interstitial, and the calcified colloid is located in the glandular cavity.
Examine
Examination of thyroid papillary cancer
1. Thyroid scan: lack of affinity for radioisotope due to thyroid cancer tissue. I or mTC can be used for thyroid scan. Most of the cancers are cold nodules. This is not a special diagnosis method. Thyroid cyst abscess adenoma can also be combined with other cold nodules. Condition diagnosis
2, serum Tg often increased after resection of differentiated tumors to restore normal Tg levels and tumor tissue structure or thyroid tumors>; thyroid tumors have no relationship between benign and malignant.
3, ultrasound examination: can be found whether the mass is cystic other thyroid function test is normal, but Hashimoto thyroiditis (also known as chronic lymphocytic thyroiditis) can be complicated by thyroid cancer.
The tumor rapidly becomes larger and compresses the trachea and infiltrates the esophagus and recurrent laryngeal nerve. The dyspnea sounds hoarseness and obstruction when swallowing food. In severe cases, lung metastasis and bone metastasis may occur.
Diagnosis
Diagnosis and diagnosis of thyroid papillary carcinoma
Thyroid mass grows faster, there are metastases, and there are obvious compression symptoms, hypothyroidism, thyroid scans, cold nodules, or abnormal thyroid CT scans and MRI images. The final diagnosis should be based on pathological biopsy. Papillary thyroid carcinoma.
