Calcitonin measurement in aspiration needle washout fluids has higher sensitivity than cytology in detecting medullary thyroid cancer: a retrospective multicentre study

Trimboli, Pierpaolo; Cremonini, Nadia; Ceriani, Luca; Saggiorato, Enrico; Guidobaldi, Leo; Romanelli, Francesco; Ventura, Claudio; Laurenti, O.; Messuti, Ilaria; Solaroli, Erica; Madaio, Raffaele; Bongiovanni, Massimo; Orlandi, Fabio; Crescenzi, Anna; Valabrega, Stefano; Giovanella, Luca

doi:10.1111/cen.12234

Cited by 84 publications

(91 citation statements)

References 25 publications

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“…The procedure may also be required in cases where serum CEA is elevated and the primary cancer is unknown [3]. The specificity and sensitivity of wash-out fluid examination are higher than those of FNAC [6,7,11]. In our study, the sensitivity was higher (96.3%) than that of FNAC (76.5%); however, false positives may occur owing to peripheral blood contamination in patients with extremely high serum calcitonin [11].…”

Section: Discussioncontrasting

confidence: 49%

“…The diagnostic accuracy of MTC on FNAC ranges from 50.0% to 82.4% [4][5][6][7]. According to a meta-analysis by Trimboli et al, the detection rate of FNAC in patients with MTC ranged from 12.5% to 88.2%, with a pooled estimate of 56.4% [14].…”

Section: Discussionmentioning

confidence: 99%

“…When FNAC is performed in cases where MTC is suspected, calcitonin measurement using needle washout fluid is useful to confirm the diagnosis of MTC [6,7,9,11,12,21]. The procedure may also be required in cases where serum CEA is elevated and the primary cancer is unknown [3].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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Section: Discussioncontrasting

confidence: 49%

Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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“…The multicenter experience of the authors of the present review showed that among 34 patients with a primary MTC (i.e. thyroid nodule), 21 (62%), and 34 (100%) were identified by conventional cytology, and FNA-CT, respectively [41]. Based on these data, a cutoff of 39.6 ng/L was calculated for practice use.…”

Section: Measurement Of Calcitonin In Fna Fluids From Thyroid Nodulesmentioning

confidence: 86%

Measurement of thyroglobulin, calcitonin, and PTH in FNA washout fluids

Trimboli

D’Aurizio

Tozzoli

et al. 2017

Clinical Chemistry and Laboratory Medicine (CCLM)

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Different imaging tools, circulating endocrine markers, and fine-needle aspiration (FNA) cytology are of great importance in the diagnosis and follow-up of different thyroid and parathyroid diseases. Sometimes, however, they are conflicting or inconclusive: interestingly, measuring endocrine markers (i.e. thyroglobulin, calcitonin, parathyroid hormone) in fluids from FNA proved to be a very useful complementary diagnostic tool in such cases. The determination of endocrine markers in fluids other than serum/ plasma has been developed in the last years. Although studies have reported overall satisfactory results, a good standardization of procedures has not yet been reached, and further efforts should be made in order to better define preanalytical, analytical, and post-analytical aspects. Here we reviewed critically the literature on the measurement of FNA endocrine markers, focusing on laboratory issues, such as preparation of the sample, choice of solution, and technical features of determination of these markers. Indeed, information for use of FNA-Tg, FNA-CT, and FNA-PTH in clinical practice was also provided.

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“…At cytopathologic examination the thyroid nodule appeared as benign (Thy 2). Cytologic specimens of the neck lesion had inadequate report, while thyroglobulin and calcitonin in washout fluids were undetectable and excluded metastasis from thyroid [2,3]. Thus, we decided to perform a core needle biopsy (CNB) of the neck mass.…”

Section: Case Reportmentioning

confidence: 99%

Neck schwannoma diagnosed by core needle biopsy: a case report

et al. 2014

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Here we present a case of a 58 year old man referred to our hospital to undergo neck and thyroid ultrasonography (US) following palpable neck mass. US revealed a solid hypoechoic nodule in right thyroid lobe, and a solid lesion on the right laterocervical neck region with ultrasound suspicious features of neoplastic lymph node. In order to achieve a diagnosis of the neck mass and to get a proper evaluation of the thyroid nodule, we decided to perform a fine-needle aspiration (FNA) of both lesions. At cytopathologic examination the thyroid nodule appeared as benign, while cytologic sampling of the neck lesion was inadequate for a proper evaluation. Thus, we performed core needle biopsy (CNB) of the neck lesion like recently proposed for thyroid lesions; also, to definitively exclude malignancy of thyroid nodule, this also underwent CNB. Histologic report of CNB confirmed benign thyroid nodule, while the neck lesion revealed a proliferation of neuronal type consistent with schwannoma. The patient has been addressed to clinical and ultrasonographic follow-up. CNB appears as a safe and minimally-invasive approach to diagnose indeterminate neck masses and avoid unnecessary diagnostic surgery.Riassunto Presentiamo il caso di un uomo di 58 anni che si sottoponeva ad ecotomografia del collo per una massa palpabile in sede laterocervicale destra. L'esame ecotomografico ha mostrato la presenza di una lesione solida nella regione laterocervicale destra del collo, con caratteristiche ecografiche sospette per linfonodo neoplastico. Contestualmente, si riscontrava un nodulo solido ipoecogeno del lobo destro della tiroide. Allo scopo di un'ulteriore definizione diagnostica, si è pertanto deciso di procedere ad esecuzione di agoaspirato ecoguidato di entrambe le lesioni, inviando per esame citologico il materiale ottenuto. Il nodulo tiroideo ha mostrato caratteri di benignità, mentre il prelievo eseguito sulla formazione del collo non è apparso adeguato per la valutazione citologica. Abbiamo così deciso di procedere a core needle biopsy della lesione del collo, eseguendo la medesima procedura anche sul nodulo tiroideo, per una conferma diagnostica. L'esame istologico ha confermato la benignità del nodulo tiroideo e la lesione del collo è risultata una proliferazione di tipo neuronale compatibile con schwannoma. Il paziente è stato quindi indirizzato a follow-up clinico ed ecografico. In conclusione, nel caso clinico da noi presentato la core needle biopsy è apparsa una procedura sicura e mini-invasiva nell'inquadramento diagnostico di una massa del collo di incerto significato all'esame ecotomografico, senza necessità di ulteriori approcci chirurgici.

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Calcitonin measurement in aspiration needle washout fluids has higher sensitivity than cytology in detecting medullary thyroid cancer: a retrospective multicentre study

Cited by 84 publications

References 25 publications

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

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

Measurement of thyroglobulin, calcitonin, and PTH in FNA washout fluids

Neck schwannoma diagnosed by core needle biopsy: a case report

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