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Related Experiment Videos

Black thyroid: a pitfall for aspiration cytology.

S Keyhani-Rofagha1, D S Kooner, S K Landas

  • 1Department of Pathology, Ohio State University, College of Medicine, Columbus 43210.

Diagnostic Cytopathology
|January 1, 1991
PubMed
Summary

Minocycline can cause black thyroid discoloration, mimicking cancer on fine-needle aspiration cytology. Pathologists must consider this drug side effect to avoid misdiagnosis.

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Area of Science:

  • Pathology
  • Endocrinology
  • Pharmacology

Background:

  • Minocycline, a tetracycline antibiotic, has been associated with black thyroid discoloration.
  • Fine-needle aspiration cytology (FNAC) is increasingly used for thyroid lesion diagnosis.

Observation:

  • This report details a second case of black thyroid preceded by FNAC.
  • Thyroidectomy was performed in both cases due to indeterminate FNAC findings.

Findings:

  • Degenerative changes in follicular cells can mimic neoplasia (nuclear hyperchromasia, chromatin clumping).
  • Pigment deposition in thyroid cells and macrophages can be obscured by other pigments like hemosiderin.
  • Special stains (Melanin stain, potassium permanganate) confirm the pigment's nature.

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Implications:

  • A history of tetracycline use is crucial for pathologists to consider black thyroid.
  • Awareness of this pitfall is important given the rise in FNAC and tetracycline use.
  • Accurate diagnosis prevents unnecessary thyroidectomies for this benign condition.