Hypercalcitoninemia and thyroid nodules: When cytology (still) matters

Luca Giovanella, Gioacchino Giugliano, Fausto A. Maffini, Fausto Chiesa, Massimo Bongiovanni

Research output: Contribution to journalArticle

Abstract

Medullary thyroid carcinoma (MTC) can assume various cytomorphological and architectural forms, mimicking other thyroid and extra-thyroid tumors and rendering the cytological and histological diagnosis challenging. Consequently, measurement of calcitonin (CT) levels is generally considered to be more accurate than cytology in diagnosing MTC. Here, we report on a patient with a multinodular goiter and significantly elevated basal CT levels; based on cytology examination and CT immunocytostains, neither MTC nor C-cell hyperplasia was detected upon final histopathological examination. CT testing has a high false-positive rate and low positive predictive value for detecting clinically relevant MTC. Judicious integration of cytological examination with immunocytochemical stains (when needed) may be useful for selecting the most appropriate therapy and avoiding overtreatment (i.e., central neck lymph node dissection in the present case). This case demonstrates that cytological examination with ancillary techniques is still valuable in patients with thyroid nodules and suspicious MTC.

Original languageEnglish
Pages (from-to)970-973
Number of pages4
JournalDiagnostic Cytopathology
Volume42
Issue number11
DOIs
Publication statusPublished - Nov 1 2014

Keywords

  • Calcitonin
  • Fineneedle aspiration cytology
  • Medullary thyroid carcinoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology
  • Medicine(all)

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