WordNet

of or relating to or constituting a follicle
a benign epithelial tumor of glandular origin

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/01/08 12:25:23」(JST)

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A thyroid adenoma is a benign tumor of the thyroid gland.

Types

Almost all thyroid adenomas are follicular adenomas.^[1] Follicular adenomas can be described as "cold", "warm" or "hot" depending on their level of function.^[2] Histopathologically, follicular adenomas can be classified according to their cellular architecture and relative amounts of cellularity and colloid into the following types:

Fetal (microfollicular) - these have the potential for microinvasion.^[3] These consist of small, closely packed follicles lined with epithelium.^[4]
colloid (macrofollicular) - these do not have any potential for microinvasion^[3]
embryonal (atypical) - have the potential for microinvasion.^[3]
Hürthle cell adenoma (oxyphil or oncocytic tumor) - have the potential for microinvasion.^[3]
Hyalinizing trabecular adenoma^[5]

Papillary adenomas are very rare.^[3]

Differential diagnosis

A thyroid adenoma is distinguished from a multinodular goiter of the thyroid in that an adenoma is typically solitary, and is a neoplasm resulting from a genetic mutation (or other genetic abnormality) in a single precursor cell.^[6] In contrast, a multinodular goiter is usually thought to result from a hyperplastic response of the entire thyroid gland to a stimulus, such as iodine deficiency.

Careful pathological examination may be necessary to distinguish a thyroid adenoma from a minimally invasive follicular thyroid carcinoma.^[6]

Presentation

A thyroid adenoma may be clinically silent ("cold" or "warm" adenoma), or it may be a functional tumor, producing excessive thyroid hormone ("hot" adenoma). In this case, it may result in symptomatic hyperthyroidism, and may be referred to as a toxic thyroid adenoma.

Morphology

Thyroid follicular adenoma ranges in diameter from 3 cm on an average, but sometimes is larger (up to 10 cm) or smaller. The typical thyroid adenoma is solitary, spherical and encapsulated lesion that is well demarcated from the surrounding parenchyma. The color ranges from gray-white to red-brown, depending upon

the cellularity of the adenoma
the colloid content.

Areas of hemorrhage, fibrosis, calcification, and cystic change, similar to what is found in multinodular goiters, are common in thyroid (follicular) adenoma, particularly in larger lesions.

Management

Most patients with thyroid adenoma can be managed by watchful waiting (without surgical excision) with regular monitoring.^[7] However, some patients still choose surgery after being fully informed of the risks.^[7] Regular monitoring mainly consists of watching for changes in nodule size and symptoms, and repeat ultrasonography or needle aspiration biopsy if the nodule grows.^[7]

References

^ Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease. St. Louis, Mo: Elsevier Saunders. p. 1117. ISBN 0-7216-0187-1.
^ "Endocrine Pathology". Retrieved 2009-05-08.
^ ^a ^b ^c ^d ^e emedicine > Thyroid, Evaluation of Solitary Thyroid Nodule > Benign Thyroid Nodules By Daniel J Kelley and Arlen D Meyers. Updated: Oct 17, 2008
^ TheFreeDictionary > microfollicular adenoma Citing: Dorland's Medical Dictionary for Health Consumers. Copyright 2007
^ Ünlütürk, U; Karaveli, G; Sak, S. D.; Erdoğan, M. F. (2011). "Hyalinizing trabecular tumor in a background of lymphocytic thyroiditis: A challenging neoplasm of the thyroid". Endocrine Practice 17 (6): e140–3. doi:10.4158/EP11138.CR. PMID 21940281.
^ ^a ^b Ramzi Cotran, Vinay Kumar, Tucker Collins (1999). Robbins Pathologic Basis of Disease, 6th Edition. W.B. Saunders. ISBN 0-7216-7335-X.
^ ^a ^b ^c Treatment section in: Welker, M.; Orlov, D. (2003). "Thyroid nodules". American family physician 67 (3): 559–566. PMID 12588078. [1]

UpToDate Contents

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English Journal

Breath testing as potential colorectal cancer screening tool.

Amal H1, Leja M2,3,4, Funka K2,3,4, Lasina I2, Skapars R2,3, Sivins A2,3, Ancans G2,3, Kikuste I2,4, Vanags A4, Tolmanis I4, Kirsners A2, Kupcinskas L5, Haick H1.
International journal of cancer. Journal international du cancer.Int J Cancer.2016 Jan 1;138(1):229-36. doi: 10.1002/ijc.29701. Epub 2015 Aug 7.
Although colorectal cancer (CRC) screening is included in organized programs of many countries worldwide, there is still a place for better screening tools. In this study, 418 breath samples were collected from 65 patients with CRC, 22 with advanced or nonadvanced adenomas, and 122 control cases. Al
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Detection of metabolites discriminating subtypes of thyroid cancer: Molecular profiling of FFPE samples using the GC/MS approach.

Wojakowska A1, Chekan M2, Marczak Ł3, Polanski K4, Lange D5, Pietrowska M6, Widlak P7.
Molecular and cellular endocrinology.Mol Cell Endocrinol.2015 Dec 5;417:149-57. doi: 10.1016/j.mce.2015.09.021. Epub 2015 Sep 28.
One of the critical issues in thyroid cancer diagnostic is differentiation between follicular adenoma, follicular carcinoma and the follicular variant of papillary carcinoma, which in some cases is not possible based on histopathological features only. In this paper we performed molecular profiling
PMID 26415588

Need for improved monitoring in patients with acromegaly.

Silverstein JM1.
Endocrine connections.Endocr Connect.2015 Dec;4(4):R59-67. doi: 10.1530/EC-15-0064. Epub 2015 Sep 17.
Acromegaly is a rare and insidious disease characterized by the overproduction of growth hormone (GH) and insulin-like growth factor 1 (IGF1) and is most commonly due to a pituitary adenoma. Patients with acromegaly who experience prolonged exposure to elevated levels of GH and IGF1 have an increase
PMID 26381160

Japanese Journal

濾胞腺腫,濾胞癌と被包型乳頭癌濾胞亜型 (特集臨床医に必要な内分泌疾患の病理学)

覚道健一,若狭朋子,太田善夫 [他]
内分泌・糖尿病・代謝内科 = Endocrinology, diabetology & metabolism 40(5), 362-366, 2015-05
NAID 40020501133

The Common Genetic Variant rs944289 on Chromosome 14q13.3 Associates with Risk of Both Malignant and Benign Thyroid Tumors in the Japanese Population

Rogounovitch Tatiana I.,Bychkov Andrey,Takahashi Meiko,Mitsutake Norisato,Nakashima Masahiro,Nikitski Alyaksandr V.,Hayashi Tomayoshi,Hirokawa Mitsuyoshi,Ishigaki Katsu,Shigematsu Kazuto,Bogdanova Tetiana,Matsuse Michiko,Nishihara Eijun,Minami Shigeki,Yamanouchi Kosho,Ito Masahiro,Kawaguchi Takahisa,Kondo Hisayoshi,Takamura Noboru,Ito Yasuhiro,Miyauchi Akira,Matsuda Fumihiko,Yamashita Shunichi,Saenko Vladimir A.
Thyroid 25(3), 333-340, 2015-03-09
… The relationship of these genetic markers to a benign tumor of the thyroid, follicular adenoma (FA), is not well established. …
NAID 120005600830