Neck
What is the sonographic presentation of patients with papillary carcinoma?
Hypoechoic thyroid mass Adjacent enlarged cervical nodes
What are sonographic findings of malignant thyroid nodules? (3)
Internal calficiations, cervical node involvement, solitary mass
The thyroid gland utilizes what to produce its hormones?
Iodine
What is the most common form of thyroid cancer?
Papillary
What is the most common malignancy of the thyroid gland?
Papillary carcinoma (75-90%)
What hormone helps maintain a steady level of serum calcium in the blood?
calcitonin
4 characteristics of secdonary hyperparathyroidism
chronic renal failure, increased serum phospates, decreased serum calcium, thyroid hyperplasia
The fluid produced by the thyroid gland that contains thyroid hormones is referred to as:
colloid
Benign features of a thyroid nodule (6)
cystic, hyperechoic, sharp-well defined borders, egg shell calcifications, thin, complete halo
Which structure lies posterior and medial to the left thyroid gland?
esophagus
Which abnormality is generally identified by a halo surrounding it?
follicular adenoma
What hormone is produced by the parathyroid glands?
parathormone
Hypercalcemia is associated with?
parathyroid adenoma
The longus colli muscle is ____ to the thyroid gland.
posterior
The minor neurovascular bundle is ____ to the thyroid gland.
posterior
The normally located parathyroid glands are ____ to the thyroid gland.
posterior
The superior extension of the thyroid isthmus is referred to as the:
pyramidal lobe
Malignant features of a thyroid nodule (5)
solid, hypoechoic, irregular borders, fine/punctuate calcs, psammoma bodies, thick incomplete halo
Which muscle is located anterior to the thyroid?
sternohyoid
ECA branches into:
superior thyroid artery
Benign congenital cysts located superior to the thyroid gland near the hyoid bone are referred to as:
thyroglossal duct cysts
What is the largest endocrine gland?
thyroid
Which hormone is most abundantly produced by the thyroid?
thyroxine
What hormones are produced by the thyroid?
thyroxine, triiodothyronine, calcitonin
In the presence of Hashimoto thyroiditis, the thyroid produces:
too few thyroid hormones
What is a thyroglossal duct cyst? (5)
1. Congenital anomaly 2. Superficial cyst in the midline 3. Anterior to the trachea and superior to the thyroid 4. Preschool-age children 5. Following an upper respiratory infection
A normal lymph node will not measure greater than?
10mm
A thyroid isthmus that measures greater than __________ is indicative of thyroid enlargement.
10mm
How many parathyroid glands are found within the adult neck?
4
What are diagnostic findings of benign thyroid nodules?
Anechoic mass, eggshell calcification, hyperechoic mass
What is a cold nodule?
Area of hypofunctioning
What is the thyroglossal duct?
As primitive cells migrate from the pharyngeal floor to become the thyroid, a residual thyroglossal duct is formed. The thyroglossal duct normally becomes obliterated in fetal life.
What are 4 clinical characteristics of chronic lymphocytic (Hashimoto's) thyroiditis?
Autoimmune disease Painless, diffuse enlargement of the thyroid Young to middle-aged women Associated with hypothyroidism
What mass commonly appears as a cold nodule in a nuclear medicine thyroid scintigram?
Benign thyroid nodules
A 6-year old patient presents with a lateral neck mass. The mass is anterior to the sternocleidomastoid muscle and lateral to the thyroid near the angle of the mandible. The mass is predominantly cystic, with enhanced through-transmission. What is the most likely diagnosis?
Branchial cleft cyst
Parathyroid glands control the release and absorption of which nutrient?
Calcium
Which could be a malignant thyroid nodule? A cold nodule or a hot nodule.
Cold nodule
Describe the sonographic features of Graves' disease. (3)
Diffusely enlarged Identical to a multinodular goiter Increased vascularity
Describe the sonographic presentation of chronic lymphocytic (Hashimoto's) thyroiditis. (3)
Diffusely, enlarged thyroid Homogenous but coarse parenchymal echo texture More hypoechoic
What are the symptoms of Graves' disease? (7)
Exophthalmos (bulging eyes) Palpable lymph nodes Muscle atrophy Localized myxedema Weight loss Tremors Nervousness
A 30-year-old patient presents for a thyroid sonogram with a history of weight loss, hair loss, and hyperthyroidism. You note that the patient has bulging eyes. What is the most likely diagnosis?
Graves disease
Hyperthyroidism associated with a diffuse goiter is associated with:
Graves disease
What is the most common cause of hyperthyroidism?
Graves disease
Which abnormality is associated with the sonographic findings of a thyroid inferno?
Graves disease
What three diseases produce diffuse enlargement of the thyroid?
Graves, Hashimoto, acute thyroiditis
What is the most common cause of hypothyroidism?
Hashimoto thyroiditis
Multiple endocrine neoplasia is a familial, autosomal dominant, adenomatous hyperplasia. Name four tumors associated with multiple endocrine neoplasia that can be visualized sonographically.
Parathyroid adenoma Pancreatic islet cell tumor Pheochromocytoma Medullary Thyroid adenoma
Name 5 tumors associated with Multiple Endocrine Neoplasia (MEN) syndrome.
Pituitary adenoma Parathyroid adenoma Medullary thyroid carcinoma Pancreatic islet cell tumor Pheochromocytoma
What are sonographic findings of an abnormal lymph node? (3)
Rounded shape, calcifications, enlargement
Which muscles are located lateral to each thyroid lobe?
Sternocleidomastoid
Which muscles are located anterior to the thyroid gland?
Strap
What is the first branch of the external carotid artery?
Superior thyroid artery
The strap muscles of the neck are ____ to the thyroid gland.
anterior
The sternocleidomastoid muscle of the neck is ____ to the thyroid gland.
anterolateral
A cystic mass noted at the mandibular angle is most likely a:
branchial cleft cyst
Which cyst is located lateral to the neck near the carotid arteries?
branchial cleft cyst
What is the normal appearance of a cervical lymph node?
hypoechoic, oblong structure with a distinct echogenic hilum
3 characteristics of primary hyperparathyroidism
increased PTH, increased serum calcium, single parathyroid adenoma
Sup and middle thyroid veins drains into:
inernal jugular vein
Thyrocervical artery branches into:
inferior thyroid artery
Inferior thyroid vein drains into:
innominate vein
Which vascular structure is located closest to the thyroid lobes?
internal carotid artery
The common carotid artery and internal jugular vein are ____ to the thyroid gland.
lateral
Which muscles are located posterior to each thyroid lobe?
longus colli
Papillary carcinoma ______ 20% and ______ 48%.
multicentric, occult