Like follicular carcinoma, unilateral hemithyroidectomy is performed for non-invasive disease, and total thyroidectomy for invasive disease. Diagnosis
It is difficult to correctly diagnose follicular neoplasms (FNs) on fine-needle aspiration cytology (FNAC) because it shares many cytological features with other mimicking lesions. Classification
It is impossible to distinguish between follicular adenoma and  carcinoma on cytological grounds. If fine needle aspiration cytology (FNAC) suggests follicular neoplasm, thyroid lobectomy should be performed to establish the histopathological diagnosis. Features sine qua non for the diagnosis of follicular carcinoma are capsular invasion and vascular invasion by tumor cells. Still, focuses of the capsular invasion should be carefully evaluated and discriminated from the capsular rupture due to FNA penetration resulting in WHAFFT (worrisome histologic alterations following FNA of thyroid). Follicular carcinoma tends to metastasize to lung and bone via the bloodstream. Papillary thyroid carcinoma commonly metastasizes to cervical lymph nodes.HMGA2 has been proposed as a marker to identify malignant tumors. Treatment
Treatment is usually surgical, followed by radioiodine. Initial treatment
If follicular cells are found on cytological testing, it is common to carry out hemithyroidectomy to distinguish between follicular adenoma and follicular carcinoma on histopathological examination, proceeding to completion thyroidectomy and postoperative radioiodine ablation where carcinoma is confirmed. This way total thyroidectomy is not carried out unnecessarily. Thyroidectomy is invariably followed by radioiodine treatment at levels from 50 to 200 millicuries following two weeks of a low iodine diet (LID). Occasionally treatment must be repeated if annual scans indicate remaining cancerous tissue.
Compression of the brachial plexus may be identified by weakness of the muscles in the hand, near the base of the thumb. Compression of the subclavian artery is often diagnosed by finding a positive Adsons sign on examination, where the radial pulse in the arm is lost during abduction and external rotation of the shoulder. A positive Adsons sign is non-specific for the presence of a cervical rib however, as many individuals without a cervical rib will have a positive test. Compression of the sympathetic chain may cause Horners syndrome. Other animals
Many vertebrates, especially reptiles, have cervical ribs as a normal part of their anatomy rather than a pathological condition. Some sauropods had exceptionally long cervical ribs; those of Mamenchisaurus hochuanensis were nearly 4 meters long. In birds, the cervical ribs are small and completely fused to the vertebrae. In mammals, the ventral parts of the transverse processes of the cervical vertebrae are the fused-on cervical ribs. Recent studies have also found a high percent of cervical ribs in woolly mammoths. It is believed that the decline in mammoth numbers may have forced inbreeding within the species which in turn had increased the number of mammoths being born with cervical ribs. Cervical ribs have been connected with leukaemia in human children, so it has given scientists new evidence to believe that the mammoths extinction was attributed to the condition. References


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