Cytomorphological analysis of histologically confirmed cases of medullary thyroid carcinoma

Mezei Tibor, Gyenge Mónika, Gurza Kriszta-Beáta, Orbán Ildikó, Réti Zsuzsanna, Pașcanu Ionela, Kolcsár Melinda
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Abstract

Abstract Medullary thyroid carcinoma (MTC) is a rare neuroendocrine malignant tumor of parafollicular C-cell origin of the thyroid gland, whose tumor cells typically produce calcitonin. The serum level of calcitonin produced by tumor cells is a sensitive tumor marker. An elevated serum level of this and the simultaneous presence of a thyroid nodule confirmed by ultrasound raise a reasonable suspicion of MTC. Still, the first-line MTC confirmation method in diagnosing MTC is fine-needle aspiration cytology (FNA). Objective: The aim of our study was the clinicopathological and cytomorphological analysis of histologically confirmed MTC cases obtained with FNA, as well as their comparison with the clinicopathological and cytomorphological characteristics of papillary thyroid carcinoma (PTC). Material and method: In our retrospective study, we analyzed the FNA cytology findings of patients with nodular goiter examined between 2013-2019 and the available clinical data. Results: In the 7-year period, 1,808 fine-needle aspiration examinations were performed, of which we identified 12 MTC and 77 PTC cases. The average age of patients diagnosed with MTC was 53±13 years. There were nine women and three men in examined cases. The average diameter of the nodules was 14±5 mm. All of our cases were of the sporadic type. The average age of patients diagnosed with MTC was greater than that of patients diagnosed with PTC (53 vs. 44 years, p=0.02367). A female predominance is observed in both diseases, although this is more pronounced in PTC. The diameter of the MTC nodules does not differ significantly from the mean size of the PTC nodules (14 vs. 17 mm, p=0.3138). The cytomorphological characteristics of the MTC cases we examined correspond to those described in the international literature, with minor differences. Conclusions: MTC is one of the rarer thyroid cancers, which is often difficult to distinguish from other types of thyroid cancer based on clinical features alone. Average age at diagnosis is greater than patients with PTC. Accurate diagnosis is critical as it requires a different approach than other types of thyroid cancer, it may require a different surgical approach, and may benefit from targeted therapy. Therefore, knowledge of the cytomorphology of MTC is essential for accurate diagnosis and optimal patient care.
组织学证实的甲状腺髓样癌的细胞形态学分析
摘要甲状腺髓样癌(MTC)是一种罕见的起源于甲状腺滤泡旁c细胞的神经内分泌恶性肿瘤,其肿瘤细胞通常产生降钙素。肿瘤细胞产生的血清降钙素水平是一种敏感的肿瘤标志物。血清中此水平升高并同时存在甲状腺结节,超声证实可合理怀疑MTC。尽管如此,诊断MTC的一线确认方法是细针穿刺细胞学(FNA)。目的:对FNA获得的经组织学证实的甲状腺乳头状癌进行临床病理和细胞形态学分析,并与甲状腺乳头状癌(PTC)的临床病理和细胞形态学特征进行比较。材料与方法:在回顾性研究中,我们分析了2013-2019年结节性甲状腺肿患者的FNA细胞学检查结果和现有临床数据。结果:7年间共行细针穿刺检查1808例,其中MTC 12例,PTC 77例。诊断为MTC的患者平均年龄为53±13岁。在接受检查的病例中,有9名女性和3名男性。结节的平均直径为14±5mm。我们所有的病例都是散发性的。MTC患者的平均年龄大于PTC患者的平均年龄(53岁vs. 44岁,p=0.02367)。两种疾病均以女性为主,但在PTC中更为明显。MTC结节的直径与PTC结节的平均大小没有显著差异(14 vs. 17 mm, p=0.3138)。我们检查的MTC病例的细胞形态学特征与国际文献中描述的一致,差异较小。结论:MTC是较为罕见的甲状腺癌之一,仅凭临床特征难以与其他类型的甲状腺癌区分。诊断时的平均年龄大于PTC患者。准确的诊断是至关重要的,因为它需要不同于其他类型甲状腺癌的方法,它可能需要不同的手术方法,并可能受益于靶向治疗。因此,了解MTC的细胞形态学对准确诊断和最佳患者护理至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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