In the case described here, tumor cells are spindle-shaped, sometimes triangular with excentric nucleus, resembling plasmacytes. Cytoplasm is scanty, pale and delicate. Eosinophilic neurosecretion granules are smaller than those observed in oncocytes. Cells are often binucleated. Chromatin is diffusely granular and there are no macronucleoli. Cells are not very cohesive.

Histologically, the tumor rather forms solid nodules than follicules. But this case is particular because a part of the tumor cells are mucus-secreting. A clear vacuole is seen, even better in histology with Alcian blue staining. Muci-carmine positive cells have been observed in 25% of the medullary carcinomas of the thyroid. These cells are called amphicrine as they produce both mucus and calcitonine.

For more general informations about medullary carcinomas, please refer to the medullary carcinoma case.

-34 year old woman.

  

 

 

Tumor cells in loosely cohesive groups. Many binucleated cells, spindle-shaped cells and cells with a secreting vacuole.  
       
  Mixture of spindle-shaped cells and mucus-secreting cells. Some slight acini formations.  
       
  Typically plasmacytoid tumor cell with eosinophilic granulations.  
       
  Mucus-secreting tumor cells with large clear vacuole.  
       
  Nodules of tumor cells moderately polymorphous.  
       
  Alcian blue staining puts in evidence cytoplasmic mucine production.  
       
 
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  Dernière mise à jour: le 31 janvier, 2004    
 

Pour en savoir plus:

Droese M: Cytological Aspiration Biopsy of the Thyroid Gland. F.K. Schattauer Verlag, Stuttgart-New-York, 1980.

Kini SR: Guides to Clinical Aspiration Biopsy. Thyroid. Igaku-Shoin, New-York-Tokyo, 1987.

LiVolsi VA: Surgical Pathology of the Thyroid. Major problems in pathology, vol 22. W.B. Saunders Co, Philadelphia, 1990.

Miller JM, Kini SR, Hamburger JI: Needle Biopsy of the Thyroid. Praeger, 1983.

Meissner WA, Warren S: Tumors of the Thyroid Gland. Atlas of tumor pathology fascicle 4. Armed Forces Institute of Pathology, 1969.

Rosai J, Carcangiu ML, DeLellis RA: Tumors of the Thyroid Gland. Atlas of tumor pathology fascicle 5. Armed Forces Insitute of Pathology, 1992.

Papaparaskeva K, Nagel H, Droese M: Cytologic diagnosis of medullary carcinoma of the thyroid gland. Diagn Cytopathol 22(6):351-358, 2000.

Kaserer K, Scheuba C, Neuhold N: C-Cell hyperplasia and medullary thyroid carcinoma in patients routinely screened for serum calcitonin. Am. J. Surg. Pathol. 22(6):722-728, 1998.

Forrest CH, Frost FA, de Boer WB: Medullary carcinoma of the thyroid. Accuracy of diagnosis by fine-needle aspiration cytology. Cancer (Cancer-Cytopathol)84(5):295-302, 1998.

Galera-Davidson H: Diagnostic problems in thyroid FNAs. Diagn Cytopathol 17(6):422-428, 1997.