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Marginal vacuoles in thyroid aspirates

D K Das1, S Jain, R P Tripathi

  • 1Institute of Cytology and Preventive Oncology, New Delhi, India.

Acta Cytologica
|October 2, 1998
PubMed
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Marginal vacuoles (MVs) in fine needle aspiration smears can indicate metastatic follicular thyroid carcinoma (FTC). This cytologic feature was observed in two metastatic FTC cases and in a significant percentage of solitary nodular goiters.

Area of Science:

  • Cytopathology
  • Endocrinology
  • Oncology

Background:

  • Follicular thyroid carcinoma (FTC) is a common endocrine malignancy.
  • Solitary nodular goiters (SNGs) are frequently encountered in clinical practice.
  • Marginal vacuoles (MVs) are a specific cytologic feature observed in thyroid fine needle aspiration (FNA) smears.

Observation:

  • Two cases of metastatic FTC presented with MVs in FNA smears from extra-thyroidal masses (hip and scalp).
  • MVs were identified in 42.6% of hyperplastic nodules within SNGs, a significantly higher rate than in colloid or neoplastic goiters.
  • MVs were predominantly found in neoplasms with a follicular component, including follicular variant of papillary carcinoma (FVPC).

Findings:

  • The presence of MVs in FNA smears aided in the diagnosis of metastatic FTC in cases where the primary thyroid tumor was not initially apparent.

Related Experiment Videos

  • The prevalence of MVs varied significantly across different types of SNGs, being highest in thyrotoxic goiter and lowest in colloid goiter.
  • MVs were significantly associated with follicular-derived neoplasms, particularly FVPC, suggesting a potential role in differentiating thyroid lesions.
  • Implications:

    • Identifying MVs in FNA smears can be crucial for diagnosing metastatic FTC, especially in cases with unknown primary tumors.
    • The differential diagnostic value of MVs in SNGs warrants further investigation for improved classification of thyroid nodules.
    • This cytologic feature may contribute to a better understanding of the histogenesis and behavior of follicular thyroid neoplasms.