Aspiration cytologic features of thyroid medullary carcinoma

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  • 甲状腺髄様癌の穿刺吸引細胞像

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Objectives : In fine needle aspiration cytology for thyroid cancer, it is difficult to discriminate the exact histological type between medullary and papillary carcinoma.<br>Study Design : Consecutive archives of thyroid tumor cases (total number 631) in last 10 years (1995-2004) were reviewed. We attempted to improve diagnostics by comparative cytological findings with electron microscopic features and by using immunocytochemical markers-calcitonin, chromogranin A, and CEA for 3 medullary carcinoma cases.<br>Results : After decoloring conventional cytological stains, immunocytochemical stains worked well. Comparative electron microscopic and cytological study revealed plausible but not definitive small cytoplasmic granular structures and fine fibral substructures in the extracellular matrix.<br>Conclusion : Careful observation of cytological specimens noting the cytological features of medullary carcinoma and the correlative interpretation of typical electron microscopic feature would reduce underestimation of the possibility of medullary carcinoma. Using single (calcitonin) but and a battery of three immunocytological markers—calcitonin, chromogranin A and CEA—would significantly improve diagnostic validity in medullary carcinoma.

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