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Value of aspiration cytology and intraoperative imprints in the diagnosis of medullary carcinoma

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, may 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. During an 8-year period, 108 fine needle aspiration biopsies under ultrasound guidance were performed in 43 patients (30 F and 13 M). In 3 patients tumor had familial occurrence. Preoperative cytologic diagnosis was based on a specific cytologic morphology of MCT in fine needle aspirates. In most patients, additional use of cytochemical method with silver nitrate stain resulted in positive argyrophilia. In 40/43 patients, cytologic diagnosis of MCT was consistent with pathohistology ; in most patients cytology pointed to papillary carcinoma, and in one patient to follicular carcinoma. However, intraoperative imprint diagnoses were positive fot MCT in all our patients. 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.

aspiration cytology; intraoperative imprints; medullary thyroid carcinoma

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