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FNAC and intraoperative imprints in the diagnosis oof medullary thyroid carcinoma

Objective: The growth of medullary carcinoma of the thyroid (MCT) is very slow but progressive, requiring an easy and reliable diagnostic method in the early stage of the disease. The variable cytologic features of MCT which reflect the histology of different subtypes of this neoplasm, my produce diagnostic problems. The aim of our study was to correlate preoperative and intraoperative cytologic diagnoses of MCT with pathohistology, to assess the value of both techniques. Methods: During a 9-year period, 125 fine needle aspiration biopsies under ultrasound guidance were performed in 53 patients (37 F annd 16M). In 5 patients tumor had familial occurrence. Preoperative cytologic diagnosis was based on a specific cytologic morphology of MCT in fine needle aspirates supported by positive immunostaining for calcitonin, chromogranin and CEA, or by additional use of cytochemical method with silver nitrate stain demonstrating argyrophilia. Results: In 50/53 patients, cytologic diagnosis of MTC was consistent with pathohistology ; in 2 patients, cytology pointed to papillary carcinoma, and in one patient to follicular carcinoma. However, intraoperative imprint diagnoses were positiv for MCT in all our patients. Conclusion: Accordingly, cytology was concluded to be an excellent method for preoperative and intraoperative diagnosis of MCT. Therefore, we strongly recommend combined use of both methods in the early diagnosis of disease.

FNAC; intraoperative imprint; medullary thyroid carcinoma

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