Fine needle aspiration cytology of mixed medullary-follicular thyroid carcinoma: A case report
Journal
Acta Cytologica
Journal Volume
52
Journal Issue
3
Pages
361-365
Date Issued
2008
Author(s)
Abstract
Background: Mixed medullary-follicular thyroid carcinoma (MMFTC) is a rare tumor that has been regarded as a clinicopathologic variant of medullary thyroid carcinoma. MMFTC represents a diagnostic challenge by fine needle aspiration cytology (FNAC). Case A 77-year-old woman had a palpable mass on the left side of the neck. It was diagnosed as follicular neoplasm by FNAC; she underwent total thyroidectomy. Pathology revealed follicular carcinoma. Radioactive iodine was administered. An enlarging mass was present in the left mandible later. FNAC showed suspicious follicular neoplasm with predominance of oncocytic cells. Pathology revealed follicular carcinoma with parafollicular cell differentiation. Immunohistochemical analysis demonstrated positive status for thyroglobulin and calcitonin. Simultaneous expression of thyroglobulin and calcitonin within the same neoplastic cell was considered. She underwent several courses of radioactive iodine therapy without significant effect. Interestingly, her serum calcitonin level was not elevated. Conclusion: Coexpression of thyroglobulin and calcitonin in the same cell is very rare. The component of medullary carcinoma should be considered when encountering an atypical thyroid carcinoma with predominance of cells showing oncocytic changes on FNAC and with clinically poor response to conventional treatment. Immunohistochemistry and pathologic analyses are helpful to confirm the diagnosis, especially in the absence of elevated serum calcitonin level. ? The International Academy of Cytology.
SDGs
Other Subjects
calcitonin; iodine 131; radioactive iodine; thyroglobulin; aged; article; aspiration biopsy; aspiration cytology; calcitonin blood level; case report; cell differentiation; diagnostic test; female; histopathology; human; human tissue; immunohistochemistry; mixed medullary follicular thyroid carcinoma; priority journal; protein expression; rare disease; thyroid follicular carcinoma; thyroid medullary carcinoma; thyroidectomy; treatment response
Publisher
S. Karger AG
Type
journal article