Thyroid cancer subtypes
- Papillary is the most common subtype of thyroid cancer, occurring mainly in young people, with female preponderance. Presentation is with a nodule and associated with lymph node metastasis. Histologically, there is an encapsulated papillae consisting of one or two layers of tumour cells surrounding a well-defined fibrovascular core. Management involves surgery and radioiodine. Papillary cancer has a good prognosis and can be monitored by measurement of thyroglobulin levels
- Follicular cancer also presents as a thyroid nodule and is associated with capsular and vascular invasion. It affects middle aged people and is more common in women. The management is similar to papillary cancer
- Hürthle/Oxyphil cell thyroid cancer is usually classified as a type of follicular thyroid cancer but it is distinct in that it grows more aggressively. Tumours can be benign or malignant
- Anaplastic cancer mainly affects the elderly and can present as a mass effect secondary to local invasion. This subtype carries a poor prognosis
- Medullary thyroid cancer is associated with raised calcitonin levels. It may be sporadic or inherited as a genetic condition called MEN2. The increased risk of malignancy is a consequence of the RET oncogene
- Lymphoma of the thyroid gland is rare and associated with Hashimoto’s. The majority of the cases are B cell lymphoma
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