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Related Experiment Videos

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
Summary

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.

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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.

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  • 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.