Exp Clin Endocrinol Diabetes 2012; 120(04): 234-237
DOI: 10.1055/s-0031-1291344
Article
© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Medullary Thyroid Nodules by Measurement of Calcitonin (Ct) in Aspiration Needle Washout in Patients with Multinodular Goiter and Moderately Elevated Serum Ct

P. Trimboli
1   Section of Endocrinology and Diabetology, Ospedale Israelitico, Rome, Italy
,
G. Nigri
2   Sapienza University 2nd School of Medicine ,Ospedale S. Andrea, Rome, Italy
,
F. Romanelli
3   Department of Experimental Medicine, Sapienza University, Rome, Italy
,
D. D. Cicciarella Modica
4   Section of Pathology, Ospedale Israelitico, Rome, Italy
,
A. Crescenzi
4   Section of Pathology, Ospedale Israelitico, Rome, Italy
,
S. Valabrega
2   Sapienza University 2nd School of Medicine ,Ospedale S. Andrea, Rome, Italy
,
L. Giovanella
5   Department of Nuclear Medicine and Thyroid Centre, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
› Author Affiliations
Further Information

Publication History

received 15 July 2011
first decision 15 July 2011

accepted 18 October 2011

Publication Date:
10 February 2012 (online)

Abstract

The accuracy of fine needle aspiration cytology (FNAC) is low in medullary thyroid carcinomas (MTC). Recently, a few papers analyzed the measurement of calcitonin (Ct) in washout of the needle after aspiration (WO-Ct) suggesting that this approach may be useful in patients with high serum Ct.

Here we reported, for the first time in our best knowledge, 3 patients with multinodular goiter, moderately elevated serum Ct, high value of WO-Ct, and medullary outcome. These findings suggest that in presence of high serum Ct, FNAC should be performed in all nodules, and it should be combined with WO-Ct in all cases.

 
  • References

  • 1 Abraham D, Gault PM, Hunt J et al. Calcitonin estimation in neck lymph node fine-needle aspirate fluid prevents misinterpretation of cytology in patients with metastatic medullary thyroid cancer. Thyroid 2009; 19: 1015-1016
  • 2 American Thyroid Association Guidelines Task Force . Kloos RT, Eng C, Evans DB et al. Medullary thyroid cancer: management guidelines of the American Thyroid Association. Thyroid 2009; 19: 565-612
  • 3 Boi F, Maurelli I, Pinna G et al. Calcitonin measurement in washout fluid from fine needle aspiration of neck masses in patients with primary and metastatic medullary thyroid carcinoma. J Clin Endocrinol Metab 2007; 92: 2115-2118
  • 4 Bugalho MJM, Santos JR, Sobrinho L. Preoperative diagnosis of medullary thyroid carcinoma: fine needle aspiration cytology as compared with serum calcitonin measurement. J Surg Oncol 2005; 91: 56-60
  • 5 Cheung K, Roman SA, Wang TS et al. Calcitonin measurement in the evaluation of thyroid nodules in the United States: a cost-effectiveness and decision analysis. J Clin Endocrinol Metab 2008; 93: 2173-2180
  • 6 Costante G, Meringolo D, Durante C et al. Predictive value of serum calcitonin levels for preoperative diagnosis of medullary thyroid carcinoma in a cohort of 5 817 consecutive patients with thyroid nodules. J Clin Endocrinol Metab 2007; 92: 450-455
  • 7 Doyle P, Düren C, Nerlich K et al. Potency and tolerance of calcitonin stimulation with high-dose calcium versus pentagastrin in normal adults. J Clin Endocrinol Metab 2009; 94: 2970-2974
  • 8 Elisei R, Bottici V, Luchetti F et al. Impact of routine measurement of serum calcitonin on the diagnosis and outcome of medullary thyroid cancer: experience in 10 864 patients with nodular thyroid disorders. J Clin Endocrinol Metab 2004; 89: 163-168
  • 9 Gharib H, Papini E, Paschke R et al., AACE/AME/ETA Task Force on Thyroid Nodules . American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. J Endocrinol Invest 2010; 33: 1-50
  • 10 Giovanella L, Suriano S. Spurious hypercalcitoninemia and heterophilic antibodies in patients with thyroid nodules. Head Neck 2010; 33: 95-97
  • 11 Kim JM, Chung KW, Kim SW et al. Spurious hypercalcitoninemia in patients with nodular thyroid disease induced by heterophilic antibodies. Head Neck 2010; 32: 68-75
  • 12 Kim SH, Kim BS, Jung SL et al. Ultrasonographic findings of medullary thyroid carcinoma: a comparison with papillary thyroid carcinoma. Korean J Radiol 2009; 10: 101-105
  • 13 Kudo T, Miyauchi A, Ito Y et al. Diagnosis of medullary thyroid carcinoma by calcitonin measurement in fine needle aspiration biopsy specimens. Thyroid 2007; 17: 635-638
  • 14 Lee S, Shin JH, Han BK et al. Medullary thyroid carcinoma: comparison with papillary thyroid carcinoma and application of current sonographic criteria. Am J Roentgenol 2010; 194: 1090-1094
  • 15 Massaro F, Dolcino M, Degrandi R et al. Calcitonin assay in wash-out fluid after fine-needle aspiration biopsy in patients with a thyroid nodule and border-line value of the hormone. J Endocrinol Invest 2009; 32: 308-312
  • 16 Saller B, Moeller L, Gorges R et al. Role of conventional ultrasound and color Doppler sonography in the diagnosis of medullary thyroid carcinoma. Exp Clin Endocrinol Diabetes 2002; 110: 403-407
  • 17 Trimboli P, Rossi F, Baldelli R et al. Measuring calcitonin in washout of the needle in patients undergoing fine needle aspiration with suspicious medullary thyroid cancer. Diagn Cytopathol 2011; May: 11 DOI: 10.1002/dc.21731.