Cytologic, Histologic and Immunocytochemical Features in Fine Needle Aspiration of Paraganglioma-like Variant of Medullary Carcinoma

Jayaram, Gita; Hayati, Jantan Nor; Yip, Cheng Har; Ranganathan, Sumithra; Taib, Nur Aishah Mohd

doi:10.1159/000325449

Cited by 6 publications

(6 citation statements)

References 13 publications

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“…Previous reports on cytology of this tumour have emphasized the predominance of cell nests with sharply defined margins. 21,22 The present case also had mostly cell groups although they were syncytial with ill-defined margins. Dispersed single cells were rare.…”

Section: Discussionmentioning

confidence: 53%

“…[6][7][8][9][10][11][12][13][14][15] However, a systematic study evaluating the cytology of medullary carcinoma with emphasis on variants and their distinction from the usual types of medullary carcinoma is not available, being restricted to a few case reports. [16][17][18][19][20][21][22][23][24][25] The present study, based on 78 aspirates, highlights the majority of medullary carcinoma variants and their cytological findings.…”

Section: Introductionmentioning

confidence: 63%

“…Paragangliomas on aspiration do tend to come in syncytial sheets and loose grouping rather than with single cells. Nuclear morphology of this subtype has been variously reported as pleomorphic 21 or monomorphic 22 on cytology. The present case showed mostly oval cells with focal spindling.…”

Section: Discussionmentioning

confidence: 99%

“…The standard diagnostic criteria for MCT are well established from a few large series evaluating cytomorphological features 6–15 . However, a systematic study evaluating the cytology of medullary carcinoma with emphasis on variants and their distinction from the usual types of medullary carcinoma is not available, being restricted to a few case reports 16–25 . The present study, based on 78 aspirates, highlights the majority of medullary carcinoma variants and their cytological findings.…”

Section: Introductionmentioning

confidence: 95%

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Fine needle aspiration cytology of medullary carcinoma of the thyroid with a focus on rare variants: a review of 78 cases

et al. 2011

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Section: Discussionmentioning

confidence: 53%

Section: Introductionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

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Fine needle aspiration cytology of medullary carcinoma of the thyroid with a focus on rare variants: a review of 78 cases

et al. 2011

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“…We screened PubMed database using PG-like MTC, paraganglioma-like thyroid carcinoma as key words. We selected seven articles and extracted eight case reports of this rare variant of MTC (3, 4, 5, 6, 7, 8, 9) (Table 1).…”

Section: Discussionmentioning

confidence: 99%

Concomitant medullary thyroid carcinoma with paraganglioma-like pattern and papillary thyroid carcinoma

Greco

Brigante

Taliani

et al. 2019

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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Summary A 74-year-old man was referred to the Endocrinology Unit because of multinodular goiter. The dominant nodule (1.7 × 1.9 × 2.4 cm), at the medium-superior third of the left lobe, was inhomogeneously hypoechoic, with irregular margins, macrocalcifications and intranodular vascularization. Fine-needle aspiration biopsy (FNAB) was performed. The cytological diagnosis was TIR 2, benign, according to the 2013 Italian thyroid cytology classification system. Moderately high serum calcitonin (s-Ct) (61.5 pg/mL, n.r. 0–7.5) and normal CEA were detected. The Ct level in FNAB wash-out fluid (Ct-FNAB) was 1450 pg/mL. Based on s-Ct and Ct-FNAB levels, patient underwent total thyroidectomy. Macroscopically, a dominant circumscribed nodule of 2 ecm was described; the histological and immunohistochemical features identified medullary thyroid carcinoma (MTC) with paraganglioma (PG)-like pattern positive for Ct, CEA and chromogranin and negative for S-100 sustentacular cells (SC). Moreover, papillary carcinoma of 3 mm in the right lobe was also associated. No areas of hyperaccumulation of the tracer were documented at Ga68 PET/CT. No RET-proto-oncogene mutations were found. Post-surgery s-Ct levels were within normal range (4 pg/mL). Two years after thyroidectomy, the patient is still disease-free. We reported a case of sporadic and rare variant of MTC: this is the ninth described case of PG-like MTC. In this case, cytologically benign, the clinical suspicion arose from high Ct values at FNAB wash-out fluid. Even if clinical behavior of this variant seems indolent, additional studies are necessary to understand prognoses and predictive factors. Learning points: Several unusual histological variants of medullary thyroid carcinoma (MTC) have been described such as spindle cell, giant cell, clear cell, melanotic, squamous, angiosarcoma-like variants; even rarer is the paraganglioma (PG)-like pattern. We here describe a case of medullary PG-like thyroid carcinoma in a 74-year-old man. This is a rare histological variant of MTC hardly diagnosed by cytology, since immunohistochemical investigations are necessary. Measurement of calcitonin both in serum and in wash-out fluid from fine-needle aspiration could be an additional tool for an early and non-invasive identification of these variants.

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Paraganglioma‐like medullary thyroid carcinoma: A case report and literature review

Hou

Chute

2020

Diagnostic Cytopathology

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Medullary thyroid carcinoma (MTC) accounts for 3%‐5% of all thyroid malignancies. Most MTC can be diagnosed by their typical cytologic and histologic morphology and immunohistochemical features. However, some rare variants of MTC may pose diagnostic difficulties on both cytology and histology. Paraganglioma‐like MTC (PLMTC) is a rare, but widely recognized variant of MTC. PLMTC is known to share morphological and architectural similarities with paraganglioma, hyalinizing trabecular tumor, and carcinomas of thyroid follicular cell origin, such as follicular carcinoma and follicular variant of papillary thyroid carcinoma. The combination of clinicopathologic features and a battery of immunohistochemical markers is essential for making a correct diagnosis. Herein, we report one case of PLMTC with both cytologic and histologic features and review the clinicopathologic features of previously reported cases.

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Cytologic, Histologic and Immunocytochemical Features in Fine Needle Aspiration of Paraganglioma-like Variant of Medullary Carcinoma

Cited by 6 publications

References 13 publications

Fine needle aspiration cytology of medullary carcinoma of the thyroid with a focus on rare variants: a review of 78 cases

Fine needle aspiration cytology of medullary carcinoma of the thyroid with a focus on rare variants: a review of 78 cases

Concomitant medullary thyroid carcinoma with paraganglioma-like pattern and papillary thyroid carcinoma

Paraganglioma‐like medullary thyroid carcinoma: A case report and literature review

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