Oncocytic Variant of Medullary Thyroid Carcinoma
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Oncocytic Variant of Medullary Thyroid Carcinoma Sule Canberk 1 & Mine Onenerk 1 & Pembegul Gunes 1 & Elif Sayman 1 & Gamze Kilicoglu 1
# Springer Science+Business Media New York 2015
Keywords Medullary thyroid carcinoma . Oncocytic variant . Fine-needle aspiration biopsy
Case History A 54-year-old woman presented with a 10-mm thyroid nodule in the left lobe that had a previous fine-needle aspiration biopsy (FNAB) diagnosis of suspicious for oncocytic follicular neoplasm according to The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). Slides were referred to our center for second opinion (Fig. 1a, b). Total thyroidectomy and cervical lymph node dissection were performed after FNAB results (Fig. 2a, b). What Is Your Diagnosis? See figure composite (Figs. 1a, b; 2a, b; and 3). Pathologic Diagnosis Cytopathologic Diagnosis: Bethesda System; Malignant Thyroid FNA; Category VI Medullary Thyroid Carcinoma (Note: Suggested Oncocytic Variant)
carcinoma. Rare intranuclear cytoplasmic pseudoinclusions were noticed. Oncocytic cells had a salt-and-pepper-textured chromatin and prominent nucleoli and were arranged in trabecular, nested, and microfollicular patterns associated with a conspicuous intraluminal shaped and cloudy colloid-like background. Binucleation, intracytoplasmic red granules, and multivacuolation were remarkable in Diff-Quikstained slides. Based on the eccentric oncocytic cytoplasmic morphology (loose granularity of oncocytic cytoplasm with red granules), medullary thyroid carcinoma was in the differential diagnosis and serum calcitonin level was ordered and found to be 27 pg/ml (normal;
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