Constitutive Cytomorphologic Features of Medullary Thyroid Carcinoma Using Different Staining Methods

(1) Background: Accurate preoperative identification of medullary thyroid carcinoma (MTC) is challenging due to a spectrum of cytomorphologic features. However, there is a scarcity of studies describing the cytomorphologic features as seen on fine-needle aspiration (FNA) smears prepared using differ...

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Published in:	Diagnostics (Basel) 2021-08, Vol.11 (8), p.1396
Main Authors:	Liu, Chih-Yi, Chen, Chien-Chin, Bychkov, Andrey, Agarwal, Shipra, Zhu, Yun, Hang, Jen-Fan, Lai, Chiung-Ru, Park, So Yeon, Li, Weiwei, Liu, Zhiyan, Jain, Deepali, Suzuki, Ayana, Hirokawa, Mitsuyoshi, Chia, Noel, Nga, Min En, Jitpasutham, Tikamporn, Keelawat, Somboon, Satoh, Shinya, Gunawardena, Dilini, Kumarasinghe, Priyanthi, Jung, Chan Kwon, Kakudo, Kennichi
Format:	Article
Language:	eng
Subjects:	Accuracy Cellular biology cytology fine-needle aspiration medullary thyroid carcinoma Morphology sensitivity specificity Stains & staining Statistical analysis thyroid Thyroid cancer Tumors
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Summary:	(1) Background: Accurate preoperative identification of medullary thyroid carcinoma (MTC) is challenging due to a spectrum of cytomorphologic features. However, there is a scarcity of studies describing the cytomorphologic features as seen on fine-needle aspiration (FNA) smears prepared using different staining methods. (2) Methods: We performed a retrospective study on MTC cases with available FNA slides from 13 hospitals distributed across 8 Asia-Pacific countries. The differences in the constitutive cytomorphologic features of MTC with each cytopreparatory method were recorded. A comparative analysis of cytologic characteristics was carried out with appropriate statistical tests. (3) Results: Of a total of 167 MTC samples retrospectively recruited, 148 (88.6%) were interpreted as MTC/suspicious for MTC (S-MTC). The staining methods used were Papanicolaou, hematoxylin-eosin, and Romanowsky stains. Seven out of the eleven cytologic criteria can be readily recognized by all three cytopreparatory methods: high cellularity, cellular pleomorphism, plasmacytoid cells, round cells, dyshesive cells, salt-and-pepper chromatin, and binucleation or multinucleation. An accurate diagnosis was achieved in 125 (84.5%) of the 148 samples whose FNAs exhibited five or more atypical features. Conclusions: The present work is the first study on MTC to compare the morphological differences among the cytologic staining techniques. We investigated the constitutive features and the reliability of diagnostic parameters. A feasible scoring system based upon cytomorphologic data alone is proposed to achieve a high degree of diagnostic accuracy.
ISSN:	2075-4418 2075-4418