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Objective: The aim of the study was to evaluate the usefulness of calcitonin (CT) assay in fine-needle aspiration biopsy (FNAB) washout fluid alone or combined with cytology in the presurgical study of medullary thyroid carcinoma (MTC) patients with thyroid nodules (TNs) and of suspicious neck MTC recurrences/metastases. Subjects and Methods:A total of 36 ultrasound-guided FNABs were performed in neck masses from 23 patients with borderline or high basal and pentagastrin-stimulated serum CT. Cytology and CT-FNAB were performed on a total of 18 TNs and three neck lymph nodes (LNs) from 12 patients examined before thyroidectomy, and on six suspicious local recurrences (LRs) and nine LNs from nine totally thyroidectomized MTC patients. On the basis of CT-FNAB values found in 15 non-MTC lesions, CT-FNAB more than 36 pg/ml was considered as indicative of MTC.Results: All 21 positive CT-FNAB lesions (10 TNs, six LNs, and five LRs), 13 with positive cytology, were confirmed as MTC at histology. Of the 15 negative CT-FNAB suspicious masses (eight TNs, six LNs, and one LR), five displayed a benign lesion at histology. The remaining 10 cases, all with benign cytology, were not operated on, and no evidence of MTC was detected at follow-up. CT-FNAB reached 100% sensitivity and specificity for MTC, while cytology displayed 61.9% sensitivity and 80% specificity. calcitonin (CT) has been proposed as a routine assay in the diagnostic evaluation of all thyroid nodules (TNs) for early detection of medullary thyroid carcinoma (MTC) (1-4). Fine-needle aspiration cytology represents the main tool in the diagnostic evaluation of TNs, but it is not frequently proposed as a routine procedure in patients with high-serum CT, due to its low sensitivity and specificity (1, 5). Neck ultrasound (US) with color flow Doppler sonography (CFDS) and US-guided fine-needle aspiration cytology is the current diagnostic approach for the identification of MTC neck lymph node (LN) metastases both before and after thyroidectomy (6 -8). A similar approach is used to identify neck recurrences/metastases of differentiated follicular and papillary thyroid carcinoma, where the assay of thyroglobulin (Tg) in fine-needle aspiration biopsy (FNAB) wash-out fluid (Tg-FNAB) represents an additional highly reliable marker (9 -11). When compared with Tg-FNAB, no study has been performed to evaluate the usefulness of CT assay in FNAB (CT-FNAB) fluid alone or combined with cytology. ConclusionsThe aim of this study was to assess the clinical usefulness of CT-FNAB in the identification of primary MTC and its neck LN metastases or recurrences. From 2003From -2006 US-guided FNABs were performed in 23 patients with high-serum CT. These included 21 lesions (18 TNs and three neck LNs) from 14 patients before thyroidectomy and 15 neck masses (six suspicious local recurrences and nine neck LNs) from nine patients after total thyroidectomy for MTC. Patients and Methods Patients studiedAll patients (13 women, age range 36 -76 yr, and 10 men, age range 25-69 yr) were submitted ...

X‐ray diffraction data for three aqueous solutions of MgCl2 were analyzed. It is shown that in a very concentrated solution the structure and correlation functions can be reproduced almost completely by using a nearest‐neighbor model of ionic hydration, whereas in the more dilute solutions a certain number of interactions between the hydrated cation and external water molecules must also be considered. The mean coordination geometry for the close hydration was found to be octahedral both for cation and anion with mean cation–water distances (2.10–2.12 Å) and mean anion–water distances (3.11–3.14 Å) in accordance with results found in other cases.

Objective: Multiple endocrine neoplasia type 2 (MEN 2) is a genetic disease characterized by medullary thyroid carcinoma (MTC) associated (MEN 2A and 2B) or not familial MTC (FMTC) with other endocrine neoplasia due to germline RET gene mutations. The prevalence of these rare genetic diseases and their corresponding RET mutations are unknown due to the small size of the study population. Methods: We collected data on germline RET mutations of 250 families with hereditary MTC followed in 20 different Italian centres. Results and conclusions: The most frequent RET amino acid substitution was Val804Met (19.6%) followed by Cys634Arg (13.6%). A total of 40 different germline RET mutations were present. Six families (2.4%) were negative for germline RET mutations. The comparison of the prevalence of RET germline mutations in the present study with those published by other European studies showed a higher prevalence of Val804Met and Ser891Ala mutations and a lower prevalence of Leu790Phe and Tyr791Phe (P!0.0001). A statistically significant higher prevalence of mutations affecting non-cysteine codons was also found (P!0.0001). Furthermore, the phenotype data collection showed an unexpected higher prevalence of FMTC (57.6%) with respect to other MEN 2 syndromes (34% MEN 2A and 6.8% of MEN 2B). In conclusion, we observed a statistically significant different pattern of RET mutations in Italian MEN 2 families with respect to other European studies and a higher prevalence of FMTC phenotype. The different ethnic origins of the patients and the particular attention given to analysing apparently sporadic MTC for RET germline mutations may explain these findings.

Two concentrated (5 and 7 mol l−1) aqueous solutions of NaNO3 were investigated by x-ray diffraction. The features of the total radial functions calculated from experimental intensity data show that the positional correlation is not very strong in the systems investigated. However, it is possible to account for experimental data only by using models in which hexahydrated Na+ ions have definite correlations with NO3− ions, even if not through formation of isolated ion pairs. The compatibility of our observations with spectroscopic results is also discussed.