scholarly journals Spindle cell variant of medullary thyroid carcinoma: a clinicopathologic study of four cases

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yan Xia Wang ◽  
Shou Jing Yang
Keyword(s):  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Spindle Cell ◽  
Regional Lymph Node ◽  
Medullary Thyroid ◽  
Fibrous Stroma ◽  
Immunohistochemical Markers ◽  
Clinicopathologic Study ◽  
Regional Lymph Node Dissection ◽  
Cell Variant

Abstract Background Medullary thyroid carcinoma (MTC) is a malignant tumor derived from C cells. It accounts for about 10% of all thyroid malignancies. More than 14 histological variants have been described. Among them, spindle cell variant is extremely rare. Case presentation Here we describe 4 cases of spindle cell variant of MTC collected from 2012 to 2019. Ultrasound showed solid and hypoechoic nodules. Three patients underwent total thyroidectomy and regional lymph node dissection, and 1 patient underwent thyroid mass resection. Histologically, the tumors showed spindle shaped cells in bundles or interlaced arrangement, separated by hyalinised fibrous stroma that contained amyloid deposits. Immunohistochemistry showed that the tumor cells were positive for calcitonin, chromogranin A, synaptophysin, CD56, and TTF-1, but negative for other lineage-specific markers. Conclusions We report 4 rare cases of spindle cell variant of MTC. Due to its rarity and special morphology, the diagnosis of spindle cell variant MTC relies on its morphology and immunohistochemical markers to avoid misdiagnosis.

scholarly journals Spindle cell variant of medullary thyroid carcinoma: a clinicopathologic study of four cases

2021 ◽  
Author(s):  
Yan Xia Wang ◽  
Shoujing Yang
Keyword(s):  
Thyroid Carcinoma ◽  
Spindle Cell ◽  
Regional Lymph Node ◽  
Fibrous Stroma ◽  
Immunohistochemical Markers ◽  
Clinicopathologic Study ◽  
Regional Lymph Node Dissection ◽  
Special Morphology ◽  
Cell Variant ◽  
Thyroid Malignancies

Abstract BackgroundMedullary thyroid carcinoma (MTC) is a malignant tumor derived from C cells. It accounts for about 10% of all thyroid malignancies. More than 14 histological variants have been described. Among them, spindle cell variant is extremely rare.Case presentationHere we describe 4 cases of spindle cell variant of MTC collected from 2012 to 2019. Ultrasound showed solid and hypoechoic nodules. Three patients underwent total thyroidectomy and regional lymph node dissection, and 1 patient underwent thyroid mass resection. Histologically, the tumors showed spindle shaped cells in bundles or interlaced arrangement, separated by hyalinised fibrous stroma that contained amyloid deposits. Immunohistochemistry showed that the tumor cells were positive for calcitonin, chromogranin A, synaptophysin, CD56, and TTF-1, but negative for other lineage-specific markers.ConclusionsWe report 4 rare cases of spindle cell variant of MTC. Due to its rarity and special morphology, the diagnosis of spindle cell variant MTC relies on its morphology and immunohistochemical markers to avoid misdiagnosis.

Hepatic Metastases from the Spindle Cell Variant of Medullary Thyroid Carcinoma

2001 ◽  
Vol 45 (6) ◽  
pp. 1022-1026 ◽  
Author(s):  
Carolina Ibarrola de Andrés ◽  
Victor Manuel Castellano Megías ◽  
Claudio Ballestin Carcavilla ◽  
Nuria Alberti Masgrau ◽  
Andrés Perez Barrios ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Spindle Cell ◽  
Hepatic Metastases ◽  
Medullary Thyroid ◽  
Cell Variant

scholarly journals Diagnosis and pathologic characteristics of medullary thyroid carcinoma—review of current guidelines

2019 ◽  
Vol 26 (5) ◽  
Author(s):  
C. M. Thomas ◽  
S. L. Asa ◽  
S. Ezzat ◽  
A. M. Sawka ◽  
D. Goldstein
Keyword(s):  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Dna Analysis ◽  
Neuroendocrine Tumour ◽  
Needle Aspiration ◽  
Differentiated Thyroid Carcinoma ◽  
Serum Calcitonin ◽  
Medullary Thyroid ◽  
Fibrous Stroma

Background Medullary thyroid carcinoma (mtc) is a rare malignancy of the thyroid gland, and raising awareness of the recommended diagnostic workup and pathologic characteristics of this malignancy is therefore important.Methods We reviewed the current clinical practice guidelines and recent literature on mtc, and here, we summarize the recommendations for its diagnosis and workup. We also provide an overview of the pathology of mtc.Results A neuroendocrine tumour, mtc arises from parafollicular cells (“C cells”), which secrete calcitonin. As part of the multiple endocrine neoplasia (men) type 2 syndromes, mtc can occur sporadically or in a hereditary form. This usually poorly delineated and infiltrative tumour is composed of solid nests of discohesive cells within a fibrous stroma that might also contain amyloid. Suspicious nodules on thyroid ultrasonography should be assessed with fine-needle aspiration (fna). If a diagnosis of mtc is made on fna, patients require baseline measurements of serum calcitonin and carcinoembryonic antigen. Calcitonin levels greater than 500 pg/mL or clinical suspicion for metastatic disease dictate the need for further imaging studies. All patients should undergo dna analysis for RET mutations to diagnose men type 2 syndromes, and if positive, they should be assessed for possible pheochromocytoma and hyperparathyroidism.Summary Although the initial diagnosis of a suspicious thyroid nodule is the same for differentiated thyroid carcinoma and mtc, the remainder of the workup and diagnosis for mtc is distinct.

scholarly journals Small Cell Variant of Medullary Thyroid Carcinoma: A Possible Treatment

Cureus ◽  
2020 ◽  
Author(s):  
John Sherret ◽  
Mohammad Alomari ◽  
Joshua Coleman ◽  
Agnes Hamati
Keyword(s):  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Small Cell ◽  
Medullary Thyroid ◽  
Small Cell Variant ◽  
Cell Variant

scholarly journals Significance of chromogranin A and synaptophysin in medullary thyroid carcinoma

2020 ◽  
Author(s):  
Tatsuo Tomita
Keyword(s):  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Immunohistochemical Staining ◽  
Chromogranin A ◽  
Serum Markers ◽  
Small Lesion ◽  
Medullary Thyroid ◽  
Sporadic Tumor ◽  
Immunohistochemical Markers ◽  
Sporadic Cases

Medullary thyroid carcinoma (MTC) is a relatively rare thyroid carcinoma of C-cell deviation and produces and secrete calcitonin (CT) and chromogranin A (CgA) into the blood. Thus, both CT and CgA are immunohistochemical and serum markers for MTCs. MTC occurs in both sporadic and inheritable cases and the hallmark of inheritable cases in multiple endocrine neoplasm 2 (NEN2) is MTC. MEN2 cases represent 30% of MTCs through germline RET protooncogene mutation and occur in younger ages involving bilateral thyroid lobes. Sporadic cases are 70% of cases of solitary tumor and occur in older ages. CgA and synaptophysin (SPY) are the two, most widely used and reliable immunohistochemical markers for neuroendocrine tumors including MTCs. This study aimed to detect different immunohistochemical staining patterns for CgA and SPY between non-symptomatic small, microscopic lesions and invading larger aggressive tumors in both MEA2 cases and sporadic cases. There was different CgA and SPY immunostaining in MEA2 cases where small tumors (≤ 0.3 cm) were lesser immunostained for CgA and SPY, despite strong staining for CT, compared to the larger (≥ 0.5cm) tumors, stronger immunostained for CgA. There was also different CgA and SPY immunohistochemical staining in sporadic cases between small lesion (≤ 0.5 cm) and larger tumors (≥ 1.0cm). One small sporadic tumor (0.5 x 0.3 cm) was strongly and weakly, patchy (about 10% of tumor tissue) stained for CgA and SPY, respectively, while larger sporadic tumors were diffusely, stronger stained for CgA and SPY. Therefore, stronger CgA and SPY immunostaining for larger tumors in both MEA2 and sporadic cases may be used as independent aggressive immunohistochemical markers for MTCs.

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