Fine‐needle aspiration biopsy of mucus‐producing medullary carcinoma of thyroid: Report of a case with cytologic, histologic, and ultrastructural correlations

Haleem, Abdul; Akhtar, Mohammed; Ali, Muhammad; Iqbal, Zafar

doi:10.1002/dc.2840060208

Cited by 17 publications

(15 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The case reports of mucinous thyroid tumors [8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27], including the current three cases, are summarized in table 2. The list does not include the mucin-negative signet ring thyroid tumors described by Schröder and Böcker [28] and commented on by LiVolsi [29].…”

Section: Discussionmentioning

confidence: 99%

Fine-Needle Aspiration of Mucin-Producing Thyroid Tumors

Yang¹,

Scognamiglio²,

Kuhel

2011

Acta Cytologica

View full text Add to dashboard Cite

Objective: Mucin-producing thyroid tumors are extremely rare. Nonetheless, we have encountered three such cases in fine-needle aspiration. We report the cytologic and histologic findings and review the literature. Study Design: Cytologic features were studied on direct smears using Romanovsky stain to detect background substance and Papanicolaou stain to analyze nuclear and cytoplasmic features. The cytologic features were correlated with histology. Mucin was demonstrated by mucicarmine, Alcian Blue/PAS, and Alcian Blue (pH 2.5). Results: The cytologic features related to mucin include: (1) thick luminal mucin globules and signet ring cells aspirated from an 83-year-old woman with a 3-cm signet ring cell follicular adenoma, (2) abundant fluffy mucin containing signet ring cells in cohesive fragments aspirated from a 75-year-old man with the bilateral signet ring cell follicular variant of papillary carcinoma, which is the first case in the English literature, and (3) abundant thin mucoid mucin aspirated from the lymph node of an 86-year-old woman with a 5-cm mucinous poorly differentiated thyroid carcinoma. Conclusion: The occurrence of mucin in thyroid fine-needle aspiration does not necessarily indicate metastasis, and the presence of mucin in cervical lymph nodes does not exclude the thyroid gland as a possible primary.

show abstract

Section: Discussionmentioning

confidence: 99%

Fine-Needle Aspiration of Mucin-Producing Thyroid Tumors

Yang¹,

Scognamiglio²,

Kuhel

2011

Acta Cytologica

View full text Add to dashboard Cite

show abstract

“…To our knowledge, only rare examples of mucin-laden vacuoles in aspirate smears of thyroid carcinoma have been reported. Haleem et al describe a case of medullary thyroid carcinoma with intracytoplasmic vacuoles containing amorphous mucin (5). Discrete intravacuolar targetoid globules are not illustrated in their example, although electron microscopy demonstrated occasional vacuoles lined by microvilli.…”

Section: Discussionmentioning

confidence: 99%

“…Although reports to the contrary have been published (2)(3)(4), our impression is that many pathologists remain under the misconception that carcinomas of the thyroid are nearly all mucin-negative. This assumption from histopathology has been transferred to fine needle aspiration (FNA) cytopathology of thyroid carcinoma, where only rare descriptions or illustrations of extracellular mucin or mucin-filled vacuoles exist (5,6). The aim of this article is to illustrate and describe the FNA cytopathology (and corresponding histopathology) of a mucinous papillary thyroid carcinoma (PTC) and to discuss the potential pitfalls related to this phenomenon.…”

mentioning

confidence: 99%

Aspiration Cytopathology of Metastatic Mucinous Papillary Thyroid Carcinoma

Morrison

Wakely

2001

Modern Pathology

View full text Add to dashboard Cite

The light microscopic histopathology and cytopathology of papillary thyroid carcinoma (PTC) and its variants is amply depicted in reviews, books, and book chapters. One of the changes in PTC, however, that is infrequently discussed or illustrated in the literature is that of mucinous metaplasia. In the aspiration cytopathology literature, we are aware of only a rare report of PTC exhibiting extensive mucinous metaplasia. We present an example correlating the histopathology and fine needle aspiration cytopathology of a PTC that had metastasized on several separate occasions to cervical lymph nodes, and in the process demonstrated mucinous trans- The presence of mucin in endocrine neoplasms is an unexpected finding in contrast to its frequent production in non-endocrine epithelial tumors. This can assume diagnostic importance if the pathologist is asked to determine the site of a mucin-producing metastatic carcinoma in a patient with either an unknown primary or a remote history of cancer. Almost four decades ago, in a large study of the surgical pathology of various metastatic neoplasms (including 93 examples of thyroid cancer), Foster et al. concluded that "the thyroid is the only site studied that can be ruled out with great assurance when one is dealing with a mucicarmine positive metastasis" (1). Although reports to the contrary have been published (2-4), our impression is that many pathologists remain under the misconception that carcinomas of the thyroid are nearly all mucin-negative. This assumption from histopathology has been transferred to fine needle aspiration (FNA) cytopathology of thyroid carcinoma, where only rare descriptions or illustrations of extracellular mucin or mucin-filled vacuoles exist (5, 6). The aim of this article is to illustrate and describe the FNA cytopathology (and corresponding histopathology) of a mucinous papillary thyroid carcinoma (PTC) and to discuss the potential pitfalls related to this phenomenon. CASE REPORTA 66-year-old man had undergone complete thyroidectomy at an outside hospital for PTC 10 years earlier after an initial right cervical lymph node biopsy revealed metastatic disease. Over the past decade, he has received three courses of radioactive iodine therapy and has had two separate surgical procedures to excise repeatedly enlarged right neck lymph nodes. On each occasion these nodes contained metastatic PTC both within the node proper and in extranodal soft tissue. No metastasis beyond the right cervical lymph node group has ever been detected.He presented to our medical center because of a third recurrence of right cervical lymphadenopathy since his initial thyroidectomy. FNA biopsy of an enlarged right cervical lymph node was performed and revealed metastatic carcinoma. Subsequent surgical resection of the aspirated node and surrounding soft tissue was performed 2 weeks after FNA confirmed that diagnosis. One year after the FNA, he presented with a fourth recurrence of a right neck mass. This was excised without performing another prior FNA, and again it reve...

show abstract

“…[8][9][10][11] However, there are only a few descriptions of ICL, not only in MCT but also in other thyroid tumors. [4][5][6]12 Lowhagen and Linsk 4 mentioned intracytoplasmic vacuoles, suggesting mucous production with MCT. They also reported that these vacuoles could not be stained for calcitonin.…”

Section: Discussionmentioning

confidence: 99%

“…Previously, MCT with intracytoplasmic vacuoles was described. [4][5][6] However, detailed descriptions with ultrastructural and immunocytochemical studies are lacking. In this report we document the cytologic, ultrastructural and immunocytochemical findings of ICL in MCT.…”

Section: Background: Intracytoplasmic Lumina (Icl) Have Been Observedmentioning

confidence: 99%