Up to now there isnt any study to validate the CT measurement in wash-out-fluid from FNAB in the diagnosis of medullary thyroid cancer (MTC). To demonstrate the usefulness of CT measurement in wash-out fluid from FNAB in thyroid nodules, we have retrospectively analyzed 25 cases with detectable serum CT in which CT measurement in wash-out-fluid from FNAB, citology and histological examination were available. In 7 cases CT level was <10 pg/ml: cytology was negative in 4 cases and not diagnostic in 3 cases. In 6 cases C cell iperplasia (ICC) or MTC was identified at histology but in a different nodule and in one case a focus of MTC was found in the punctured nodule. In 6 cases the CT level was 10<CT<1000 pg/ml: an MTC was found in 5 cases at histology; in one case a papillary thyroid carcinoma (PTC) was found both at histology and citology. Citology described a MTC in 2 cases and was not diagnostic in 3 cases. In 6 cases CT level was 1000<CT<10000 pg/ml. In all cases the histology described a MTC with the exception of one case in which there was a PTC. Citology found 4 cases of MTC, but it was not diagnostic in 2 cases. In 6 cases CT levels was >10000 pg/ml: in all cases a MTC was described both at histology and citology.
In conclusion CT level <10 pg/ml in wash-out-fluid from FNAB was indicative of absence of cancer in 86% of cases. The citology identifies only 57% of benign nodules. CT level >10 pg/ml in FNAB was indicative of presence of malignant or premalignant in 100% of cases (15 MTC; 1 ICC; 2 PTC), while cytology only in 72% of cases. We conclude that CT measurement in wash-out-fluid from FNAB increases diagnostic sensibility of citology from 65% to 95% and it represents an useful diagnostic tool to associate with citology when an MTC is suspected.
28 Apr - 02 May 2007
European Society of Endocrinology