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  #1  
Old 01-18-2012
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Default endocrine pathology Q

A 60-year-old woman has felt a “lump” on the right side of her neck for several months. On physical examination, she
has a firm 3-cm mass in the right lobe of the thyroid gland. There is no palpable lymphadenopathy. Laboratory studies
show a serum TSH level of 3 mU/L and a T4 level of 8.8 μg/dL. A fine-needle aspiration biopsy is done, and she
undergoes a thyroidectomy. A 3-cm solid mass is present within the right thyroid lobe. Six months later, she visits her
physician again because of pain in the right thigh. A radiograph shows a fracture of the right femur in an area of lytic bone
destruction. A radioiodine scan shows uptake localized to the region of the fracture. Which of the following was most likely
to have been present in the patient's thyroid gland?
□ (A) Anaplastic carcinoma
□ (B) Follicular carcinoma
□ (C) Granulomatous thyroiditis
□ (D) Hashimoto thyroiditis
□ (E) Medullary carcinoma
□ (F) Non-Hodgkin lymphoma
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  #2  
Old 01-18-2012
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I m guessing Medullary thyroid Ca
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Old 01-18-2012
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E.

it secretes calcitonin, which resorbs the bone to increase serum Ca2+, thereby making the bone weaker and susceptible to fractures.
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Old 01-18-2012
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Ans is B Follicular Ca as it spreads by blood thus more risk then papillary which spreads by lymph first and calcitonin from medullary Ca deposits more Calcium on the bone rather than resorption which is done by parathyroid gland .... hence follicular CA appears the answer to me ......
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Old 01-18-2012
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Quote:
Originally Posted by Hitman View Post
Ans is B Follicular Ca as it spreads by blood thus more risk then papillary which spreads by lymph first and calcitonin from medullary Ca deposits more Calcium on the bone rather than resorption which is done by parathyroid gland .... hence follicular CA appears the answer to me ......
oh man im such a n00b, i saw bone and assumed calcitonin but yea calcitonin deposits bone not resorbs it! (i always confuse calcitonin and calitriol!).

hmm i suppose the only other way it could reach the bone then is via the blood so follicular carcinoma makes sense

good eye hitman.
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Yup follicular carcinoma..........
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Old 01-19-2012
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Correct Answer the correct answer is > B follicular carcinoma

as dr hitman explained greatly follicular carcinoma spread by blood so its common to cause metatses to bone while medullary carcinoma which is less common and spread through lymphatics make it not the correct answer
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