Medullary thyroid cancer biopsy

	Medullary thyroid cancer Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]

Overview

On biopsy, medullary thyroid cancer is characterized by interstitial edema and coarse calcifications.

Key Biopsy Findings in Medullary Thyroid Cancer

Microscopic Pathology

Microscopic features of medullary thyroid cancer is as follows:

Cytoplasm and Nuclei

Nested with delicate vascular septa
Trabecular cells
Tubular/glandular, pseudo-papillary cells
Polygonal to spindle to small cells
Amphophilic, somewhat granular cytoplasm
Interstitial edema
Vascular stroma may have amyloid deposits with fluffy appearing acellular eosinophilic material in the cytoplasm
Stroma can show hemorrhage, hyalinised collagen, oedema or metaplastic bone
Coarse calcification and psammoma bodies may be present
Nuclei with "neuroendocrine features"
Small, round nuclei.
Coarse chromatin (salt and pepper nuclei)

Surrounding Thyroid

+/-C-cell hyperplasia - seen with familial forms of medullary thyroid cancer
C cells (AKA parafollicular cell): abundant cytoplasm - clear/pale

Biopsy Exams of Medullary Thyroid Cancer

Low magnification micrograph of medullary thyroid carcinoma<ref> Medullary thyroid cancer librepathology
High magnification micrograph of medullary thyroid carcinoma<ref> Medullary thyroid cancer librepathology
High magnification micrograph of medullary thyroid carcinoma<ref> Medullary thyroid cancer librepathology
Low magnification micrograph of medullary thyroid carcinoma<ref> Medullary thyroid cancer librepathology
Medullary thyroid carcinoma amyloid<ref> Medullary thyroid cancer librepathology
Medullary thyroid carcinoma amyloid<ref> Medullary thyroid cancer librepathology
Medullary thyroid carcinoma amyloid<ref> Medullary thyroid cancer librepathology
Medullary thyroid carcinoma amyloid<ref> Medullary thyroid cancer librepathology
Medullary thyroid carcinoma amyloid<ref> Medullary thyroid cancer librepathology
Medullary thyroid carcinoma comedonecrosis<ref> Medullary thyroid cancer librepathology
Medullary thyroid carcinoma comedonecrosis<ref> Medullary thyroid cancer librepathology
Medullary thyroid carcinoma comedonecrosis<ref> Medullary thyroid cancer librepathology
Medullary thyroid carcinoma spindle cell<ref> Medullary thyroid cancer librepathology
Medullary thyroid carcinoma spindle cell<ref> Medullary thyroid cancer librepathology
Medullary thyroid carcinoma spindle cell<ref> Medullary thyroid cancer librepathology
Medullary thyroid carcinoma spindle cell<ref> Medullary thyroid cancer librepathology
Medullary thyroid carcinoma spindle cell<ref> Medullary thyroid cancer librepathology
Medullary thyroid carcinoma<ref> Medullary thyroid cancer librepathology