Fine-needle aspiration cytology for medullary thyroid carcinoma: a single institutional experience in Japan

Endocrine journal

Aki Ito¹  Naoki Yamao¹  Nami Takada¹  Ayana Suzuki¹  Miyoko Higuchi¹  Mitsuyoshi Hirokawa²  Toshitetsu Hayashi²  Seiji Kuma²  Akira Miyauchi³ 

[1] Department of Clinical Laboratory, Kuma Hospital, Kobe, Japan;Department of Diagnostic Pathology and Cytology, Kuma Hospital, Kobe, Japan;Department of Surgery, Kuma Hospital, Kobe, Japan

关键词: Medullary thyroid carcinoma;    Calcitonin;    Needle wash-out fluid;    Immunocytochemical staining;    Fine-needle aspiration cytology;   

DOI  :  10.1507/endocrj.EJ17-0238

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

Many cytological studies on medullary thyroid carcinoma (MTC) have been reported; however, such studies in large series of patients with MTC have not been performed.We investigated MTC at a single institution in Japan using fine-needle aspiration cytology (FNAC), and aimed to establish a preoperative diagnostic algorithm for MTC.FNAC was performed in 119 of 149 patients with MTC (79.9%) who ultimately underwent surgical resection.Moreover, 22 of 56 hereditary MTC (39.3%) were diagnosed preoperatively without FNAC by their high serum calcitonin levels or increased response to calcium stimulation (11 cases each), as well as RET mutation analysis.On FNAC, 76.5% of nodules were categorized as ‘malignancy’ or ‘suspicious for malignancy’.The sensitivity and specificity of calcitonin measurement in aspiration needle wash-out fluid and in immunocytochemical staining for calcitonin were 96.3% and 92.3% respectively.We proposed an algorithm for preoperative diagnosis of MTC utilizing FNAC When thyroid nodules are highly suspicious for MTC by their clinical and ultrasonographic features, serum calcitonin measurement with or without a calcium stimulation test is required.Furthermore, FNAC should be performed for patients who do not have those findings.When there is a possibility of MTC at the time of FNAC, calcitonin measurement using needle wash-out fluid is a reliable diagnostic tool.When MTC is suspected on cytological examination, immunocytochemical staining for calcitonin is useful for confirming MTC diagnosis.

【 授权许可】

Unknown