Role of FNA cytology and immunochemistry in the diagnosis and management of medullary thyroid carcinoma

Report of six cases and review of the literature

Punam Bhanot, Jack Yang, Vicki J. Schnadig, Roberto Logroño

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Medullary thyroid carcinoma (MTC) is a rare neuroendocrine thyroid malignancy. This study retrospectively reviewed 10 fine-needle aspiration samples from six MTC patients. Aspirated specimens were from thyroid (3), cervical lymph nodes (5), left lung (1), and anterior chest wall (1). Cytomorphology consisted predominantly of plasmacytoid cells (3 cases), spindle cells (2 cases), and epithelioid cells (1 case). However, all specimens had a mixture of other cell types and "salt and pepper" chromatin. Only one specimen showed Congo-red-positive amyloid. Calcitonin was expressed in 7/7 specimens. Four patients underwent surgical excision and MTC was confirmed in all four. Follow-up studies included serum calcitonin (3/6 cases) and imaging (2/6 cases). One patient had MTC associated with multiple endocrine neoplasia IIA syndrome and one had familial MTC with a history of MTC in mother. In conclusion, the cytomorphology of MTC is typical and calcitonin immunostain is a reliable method for confirming primary or metastatic MTC. Early cytological diagnosis of MTC positively impacted patient management. Follow-up with serum calcitonin and imaging is helpful in the early detection of recurrences.

Original languageEnglish (US)
Pages (from-to)285-292
Number of pages8
JournalDiagnostic Cytopathology
Volume35
Issue number5
DOIs
StatePublished - May 2007

Fingerprint

Immunochemistry
Cell Biology
Calcitonin
Thyroid Gland
Multiple Endocrine Neoplasia
Congo Red
Epithelioid Cells
Medullary Thyroid cancer
Thoracic Wall
Fine Needle Biopsy
Serum
Amyloid
Chromatin
Early Diagnosis
Salts
Lymph Nodes
Mothers
Recurrence
Lung

Keywords

  • Diagnosis
  • FNA cytology
  • Immunochemistry
  • Management
  • Medullary carcinoma
  • Thyroid

ASJC Scopus subject areas

  • Anatomy

Cite this

Role of FNA cytology and immunochemistry in the diagnosis and management of medullary thyroid carcinoma : Report of six cases and review of the literature. / Bhanot, Punam; Yang, Jack; Schnadig, Vicki J.; Logroño, Roberto.

In: Diagnostic Cytopathology, Vol. 35, No. 5, 05.2007, p. 285-292.

Research output: Contribution to journalArticle

@article{37bd7665139f4a4cafad1b66ce2a8c4b,
title = "Role of FNA cytology and immunochemistry in the diagnosis and management of medullary thyroid carcinoma: Report of six cases and review of the literature",
abstract = "Medullary thyroid carcinoma (MTC) is a rare neuroendocrine thyroid malignancy. This study retrospectively reviewed 10 fine-needle aspiration samples from six MTC patients. Aspirated specimens were from thyroid (3), cervical lymph nodes (5), left lung (1), and anterior chest wall (1). Cytomorphology consisted predominantly of plasmacytoid cells (3 cases), spindle cells (2 cases), and epithelioid cells (1 case). However, all specimens had a mixture of other cell types and {"}salt and pepper{"} chromatin. Only one specimen showed Congo-red-positive amyloid. Calcitonin was expressed in 7/7 specimens. Four patients underwent surgical excision and MTC was confirmed in all four. Follow-up studies included serum calcitonin (3/6 cases) and imaging (2/6 cases). One patient had MTC associated with multiple endocrine neoplasia IIA syndrome and one had familial MTC with a history of MTC in mother. In conclusion, the cytomorphology of MTC is typical and calcitonin immunostain is a reliable method for confirming primary or metastatic MTC. Early cytological diagnosis of MTC positively impacted patient management. Follow-up with serum calcitonin and imaging is helpful in the early detection of recurrences.",
keywords = "Diagnosis, FNA cytology, Immunochemistry, Management, Medullary carcinoma, Thyroid",
author = "Punam Bhanot and Jack Yang and Schnadig, {Vicki J.} and Roberto Logro{\~n}o",
year = "2007",
month = "5",
doi = "10.1002/dc.20502",
language = "English (US)",
volume = "35",
pages = "285--292",
journal = "Diagnostic Cytopathology",
issn = "8755-1039",
publisher = "Wiley-Liss Inc.",
number = "5",

}

TY - JOUR

T1 - Role of FNA cytology and immunochemistry in the diagnosis and management of medullary thyroid carcinoma

T2 - Report of six cases and review of the literature

AU - Bhanot, Punam

AU - Yang, Jack

AU - Schnadig, Vicki J.

AU - Logroño, Roberto

PY - 2007/5

Y1 - 2007/5

N2 - Medullary thyroid carcinoma (MTC) is a rare neuroendocrine thyroid malignancy. This study retrospectively reviewed 10 fine-needle aspiration samples from six MTC patients. Aspirated specimens were from thyroid (3), cervical lymph nodes (5), left lung (1), and anterior chest wall (1). Cytomorphology consisted predominantly of plasmacytoid cells (3 cases), spindle cells (2 cases), and epithelioid cells (1 case). However, all specimens had a mixture of other cell types and "salt and pepper" chromatin. Only one specimen showed Congo-red-positive amyloid. Calcitonin was expressed in 7/7 specimens. Four patients underwent surgical excision and MTC was confirmed in all four. Follow-up studies included serum calcitonin (3/6 cases) and imaging (2/6 cases). One patient had MTC associated with multiple endocrine neoplasia IIA syndrome and one had familial MTC with a history of MTC in mother. In conclusion, the cytomorphology of MTC is typical and calcitonin immunostain is a reliable method for confirming primary or metastatic MTC. Early cytological diagnosis of MTC positively impacted patient management. Follow-up with serum calcitonin and imaging is helpful in the early detection of recurrences.

AB - Medullary thyroid carcinoma (MTC) is a rare neuroendocrine thyroid malignancy. This study retrospectively reviewed 10 fine-needle aspiration samples from six MTC patients. Aspirated specimens were from thyroid (3), cervical lymph nodes (5), left lung (1), and anterior chest wall (1). Cytomorphology consisted predominantly of plasmacytoid cells (3 cases), spindle cells (2 cases), and epithelioid cells (1 case). However, all specimens had a mixture of other cell types and "salt and pepper" chromatin. Only one specimen showed Congo-red-positive amyloid. Calcitonin was expressed in 7/7 specimens. Four patients underwent surgical excision and MTC was confirmed in all four. Follow-up studies included serum calcitonin (3/6 cases) and imaging (2/6 cases). One patient had MTC associated with multiple endocrine neoplasia IIA syndrome and one had familial MTC with a history of MTC in mother. In conclusion, the cytomorphology of MTC is typical and calcitonin immunostain is a reliable method for confirming primary or metastatic MTC. Early cytological diagnosis of MTC positively impacted patient management. Follow-up with serum calcitonin and imaging is helpful in the early detection of recurrences.

KW - Diagnosis

KW - FNA cytology

KW - Immunochemistry

KW - Management

KW - Medullary carcinoma

KW - Thyroid

UR - http://www.scopus.com/inward/record.url?scp=34247520136&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34247520136&partnerID=8YFLogxK

U2 - 10.1002/dc.20502

DO - 10.1002/dc.20502

M3 - Article

VL - 35

SP - 285

EP - 292

JO - Diagnostic Cytopathology

JF - Diagnostic Cytopathology

SN - 8755-1039

IS - 5

ER -