Cytologic diagnosis of medullary thyroid carcinoma

alwin shared this article with you from Inoreader Cytologic diagnosis of medullary thyroid carcinoma in the Asia‐Pacific region Via Diagnostic Cytopathology Abstract Background The accurate preoperative identification of medullary thyroid carcinoma (MTC) is challenging due to the rarity of tumor and variable cytologic appearance. The Asian experience with diagnosing MTC by fine‐needle aspiration (FNA) was scarcely reported. Methods Cases of MTC with available FNA slides were enrolled from 13 hospitals representing 8 Asia‐Pacific countries. Clinicopathological information, including sample preparation technique, staining method, original cytologic diagnosis and review diagnosis were collected. Results Of a total of 145 MTC cases retrospectively recruited, 99 (68.3%) were initially interpreted as MTC/suspicious for MTC (S‐MTC). The distribution of original FNA diagnostic categories was not associated with the staining method or sample preparation technique. The staining methods used were Papanicolaou, hematoxylin‐eosin and Romanowsky stains. Liquid‐based cytology (LBC) was used only in three countries. After reviewing all cases, the diagnostic rate of MTC/S‐MTC increased to 91.7% (133/145). Cases with initially unrecognized MTC had either marked pleomorphism or cytology mimicking papillary carcinoma or follicular neoplasm. Although LBC provided certain benefits, there was no significant difference in diagnostic accuracy between conventional smear and LBC. Immunocytochemistry was available in 38 cases (26.2%), all of which were correctly recognized as MTC. Conclusion Our report summarizes how MTC is handled in contemporary Asian thyroid FNA practice. Although the detection rate of MTC by cytology alone is less satisfactory, integration with ancillary tests could achieve an excellent performance. The recognition of constitutive cytomorphologic features is needed for each cytopreparatory method, which may result in a lower threshold to initiate further workup for MTC. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.