Cytomorphological Features of Medullary Thyroid Carcinoma: An Analysis based on 41 Ultrasoundguided Fine-needle Aspiration Specimens

JOURNAL TITLE: World Journal of Endocrine Surgery

Author
1. Farhana Siddiqui
2. Raghunandan Prasad
3. Azfar Neyaz
4. Neha Nigam
5. Sushila Jaiswal
6. Hira Lal
7. Gyan Chand
ISSN
0975-5039
DOI
10.5005/jp-journals-10002-1229
Volume
10
Issue
2
Publishing Year
2018
Pages
11
Author Affiliations
    1. Goyal MRI and Diagnostic Centre, New Delhi, India
    2. Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
    1. Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
    1. Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
    1. Department of Radiodiagnosis, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
    1. Department of Pathology, FH Medical College and Hospital Agra, Uttar Pradesh, India
    1. Department of Pathology, King George\'s Medical University Lucknow, Uttar Pradesh, India
    1. Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
  • Article keywords
    Fine-needle aspiration cytology, Fine-needle aspiration cytology thyroid, Medullary thyroid carcinoma, Thyroid carcinoma.

    Abstract

    Introduction: Medullary thyroid carcinoma (MTC) is a malignant tumor of thyroid gland showing parafollicular or C-cell differentiation. Aims and objectives: The current study was undertaken to evaluate safety of ultrasound-guided thyroid fine-needle aspiration cytology (FNAC) and to assess cytomorphological features of MTC in FNA specimens from 28 patients. Materials and methods: The study was performed by retrospectively reviewing the clinical and pathological records of MTC cases managed at our institute. Results: The patients included 18 males and 10 females with a mean age of 45.3 years; 24 specimens were taken from thyroid, 15 from cervical lymph nodes and one each from liver space occupying lesion and chest wall nodule. There was no complication noted during ultrasound-guided FNAC in these patients. The smears had variable cellularity in the form of moderate cellularity in 63% of specimens and low cellularity in 15% of specimens. Cell arrangements were solid cohesive in 39% of cases and microfollicular clusters in 36% of cases. The frequent microfollicles in two specimens prompted the differential of follicular carcinoma. Dispersed population was noted in 90% of specimens. Binucleated and multinucleated cells were seen in 58 and 53% specimens respectively. Only spindle cell morphology was noted in 2% of specimens. Central to eccentric nuclei were present in 39% of specimens, while 13% of specimens showed mainly eccentric nuclei. In all the specimens, neuroendocrine type of salt and pepper-like morphology was present which is best seen with Papanicolaou (Pap) stain. Similarly, cytoplasm showed granules in 78% and fine vacuoles in 29% of specimens. Amyloid appreciated as flecks or aggregates of amorphous pink or gray color was seen in 37% of specimens. No mitosis was noted in any specimen, while necrosis was seen in only in one specimen. Conclusion: Ultrasound-guided FNAC is a fairly accurate, relatively safe, rapid, and simple tool for preoperative diagnosis of thyroid malignancies. Although the cytological features of MTC are well described, different patterns may pose a diagnostic difficulty.

    © 2019 Jaypee Brothers Medical Publishers (P) LTD.   |   All Rights Reserved