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Hypercalcitoninemia and thyroid nodules
Author(s) -
Giovanella Luca,
Giugliano Gioacchino,
Maffini Fausto A.,
Chiesa Fausto,
Bongiovanni Massimo
Publication year - 2014
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/dc.23102
Subject(s) - medicine , thyroid , thyroid nodules , histopathological examination , calcitonin , radiology , pathology , thyroid carcinoma , lymph node , goiter , work up
Medullary thyroid carcinoma (MTC) can assume various cytomorphological and architectural forms, mimicking other thyroid and extra‐thyroid tumors and rendering the cytological and histological diagnosis challenging. Consequently, measurement of calcitonin (CT) levels is generally considered to be more accurate than cytology in diagnosing MTC. Here, we report on a patient with a multinodular goiter and significantly elevated basal CT levels; based on cytology examination and CT immunocytostains, neither MTC nor C‐cell hyperplasia was detected upon final histopathological examination. CT testing has a high false‐positive rate and low positive predictive value for detecting clinically relevant MTC. Judicious integration of cytological examination with immunocytochemical stains (when needed) may be useful for selecting the most appropriate therapy and avoiding overtreatment (i.e., central neck lymph node dissection in the present case). This case demonstrates that cytological examination with ancillary techniques is still valuable in patients with thyroid nodules and suspicious MTC. Diagn. Cytopathol. 2014;42:970–973. © 2014 Wiley Periodicals, Inc.