Cytological aspects of melanotic variant of medullary thyroid carcinoma

Abstract

We had the opportunity to examine a case of fine‐needle aspiration (FNA) of a melanotic variant of medullary thyroid carcinoma (MTC) in a 20‐yr‐old man. The patient presented a single node, hardened and mobile upon deglutition, in the right lobe of the thyroid, for 9 mo, without symptoms of glandular dysfunction. Calcitonin (138 pg/ml), urinary calcium (177 mg/dl), and the carcinoembryonic antigen (341 ng/ml) were increased. The nodular aspirate, drawn by FNA, was represented by pleomorphic cells, with frequent intranuclear cytoplasmic inclusions, sometimes bi‐ or multinucleated, with abundant, finely granular cytoplasm, sometimes containing a brown pigment resembling melanin. An immunohistochemical study using monoclonal antibodies (Dako Corp., Carpinteria, CA) showed that the neoplastic cells were intensely and diffusely positive for calcitonin and chromogranin, and focally positive for HMB45. In view of these findings, the case was characterized as a melanotic variant of medullary carcinoma, a rare type of neoplasia, but having a prognosis similar to the classical variant of MTC. Diagn. Cytopathol. 2001;24:206–208. © 2001 Wiley‐Liss, Inc.

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

“…Medullary carcinoma is well known for rare pigment production 37 . The cytology of pigmented MCT is available from an earlier report in which tumour cells showed pleomorphism, intranuclear inclusions and finely granular cytoplasm containing melanin‐like pigment 16 . In the present series, there were two cases, both of which had been missed at routine cytology.…”

“…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.…”

Concurrent thoracic mesothelioma and thyroid C‐cell adenoma with amyloid deposition in an aged horse

“…C‐cell carcinomas are typically more densely cellular versus their benign counterparts and the neoplastic cells are more pleomorphic (de Lima et al . ). The C‐cell tumour in this case did not display features of malignancy, such as local tissue invasion, lymphovascular invasion and metastasis to distant sites.…”

An Unusual Presentation of Medullary Thyroid Carcinoma

“…Classically tumor cells are round to polygonal with amphophilic granular cytoplasm and have medium sized nucleus. Tumor cells are spread in solid sheets separated by highly vascular stroma, hyalinised collagen and amyloid [4].…”