Cytological aspects of melanotic variant of medullary thyroid carcinoma

• Published in: Diagnostic cytopathology Vol. 24; no. 3; pp. 206 - 208
• Main Authors: de Lima, Marcus Aurelho, Dias Medeiros, Juliana, Rodrigues da Cunha, Liane, de Cássia Caldas Pessôa, Rita, Silveira Tavares, Fernanda, de Fátima Borges, Maria, Marinho, Eurípedes Oliveira
• Format: Journal Article
• Language: English
• Published: New York John Wiley & Sons, Inc 01-03-2001; Wiley-Liss
• Subjects: Adult; Antigens, Neoplasm; Biological and medical sciences; Carcinoma, Medullary - diagnosis; Carcinoma, Medullary - pathology; Carcinoma, Medullary - surgery; Diagnosis, Differential; Endocrinopathies; fine-needle aspiration; Humans; immunohistochemistry; Male; Malignant tumors; Medical sciences; medullary carcinoma; melanin; Melanins - analysis; Melanocytes - pathology; Melanoma - diagnosis; Melanoma - pathology; Melanoma-Specific Antigens; Neoplasm Proteins - analysis; thyroid; Thyroid Neoplasms - diagnosis; Thyroid Neoplasms - pathology; Thyroid Neoplasms - surgery; Thyroid. Thyroid axis (diseases); Thyroidectomy; Endocrinopathy; Human; Immunohistochemistry; Process variant; Thyroid diseases; Male; Thyroid gland; Malignant tumor; Aspiration punction; Case study; Pathology; Fine needle; Medullary carcinoma; Adult; Cytopathology; Diagnosis; Melanin
• ISSN: 8755-1039; 1097-0339
• DOI: 10.1002/1097-0339(200103)24:3<206::AID-DC1042>3.0.CO;2-H

We had the opportunity to examine a case of fine‐needle aspiration (FNA) of a melanotic variant of medullary thyroid carcinoma (MTC) in a 20‐yr‐old man. The patient presented a single node, hardened and mobile upon deglutition, in the right lobe of the thyroid, for 9 mo, without symptoms of glandular dysfunction. Calcitonin (138 pg/ml), urinary calcium (177 mg/dl), and the carcinoembryonic antigen (341 ng/ml) were increased. The nodular aspirate, drawn by FNA, was represented by pleomorphic cells, with frequent intranuclear cytoplasmic inclusions, sometimes bi‐ or multinucleated, with abundant, finely granular cytoplasm, sometimes containing a brown pigment resembling melanin. An immunohistochemical study using monoclonal antibodies (Dako Corp., Carpinteria, CA) showed that the neoplastic cells were intensely and diffusely positive for calcitonin and chromogranin, and focally positive for HMB45.
In view of these findings, the case was characterized as a melanotic variant of medullary carcinoma, a rare type of neoplasia, but having a prognosis similar to the classical variant of MTC. Diagn. Cytopathol. 2001;24:206–208. © 2001 Wiley‐Liss, Inc.