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Recommendations for reporting C cell pathology of the thyroid.
Klaus Kaserer1, Christian Scheuba, Nikolaus Neuhold
1Clinical Department of Pathology, Kaiserin Elisabeth Spital, Vienna, Austria. k.kaserer@akh-wien.ac.at
Wiener Klinische Wochenschrift
|July 2, 2002
Summary
Abnormal pentagastrin tests reliably detect medullary thyroid carcinoma (MTC) and C cell hyperplasia. Early detection through thyroid screening programs is crucial for managing hereditary tumors and improving patient outcomes.
Area of Science:
- Endocrinology
- Surgical Pathology
- Oncology
Background:
- Calcitonin screening aids early medullary thyroid carcinoma (MTC) detection, even in those without hereditary tumor risk factors.
- Increased thyroidectomies are anticipated due to abnormal pentagastrin tests.
- This study provides recommendations for reporting C cell pathology.
Purpose of the Study:
- To assess the diagnostic yield of pentagastrin testing for C cell disorders.
- To correlate histological findings with clinical outcomes.
- To establish reporting guidelines for C cell pathology.
Main Methods:
- Total thyroidectomy was performed on all patients.
- Germ-line mutations in the RET-Protooncogene were analyzed.
- Surgical specimens underwent conventional histology and immunohistochemistry for C cell assessment.
Main Results:
- Of 110 patients with abnormal pentagastrin tests, 55% had MTC and 45% had C cell hyperplasia.
- C cell hyperplasia was found in both familial and sporadic MTC cases.
- C cell changes and most MTCs were located in the upper thyroid lobes, detectable via frozen sections.
Conclusions:
- Abnormal pentagastrin stimulation indicates either MTC or C cell hyperplasia.
- Examining the upper two-thirds of thyroid lobes is vital for detecting C cell hyperplasia and small MTCs.
- Intraoperative frozen sections effectively detect most MTCs; reporting C cell hyperplasia is important, though its familial risk indication is limited.