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PubMed1991

[Beneficial effects of fructose-1,6-diphosphate infusion on hepatic regeneration after partial hepatectomy by microwave tissue coagulator].

Experiments were performed to explore the effect of microwave tissue coagulator (MTC) on post-lobectomy regeneration of the liver and the regeneration-promoting effect of fructose-1,6-diphosphate (FDP) on heat injury of the liver after 40% hepatectomy in rats. Concerning the effect of MTC on hepatic regeneration, a MTC group showed a significantly higher serum LDH level on post-operative day 2, compared with a simple ligation group. A significant difference in DNA synthesizing activity between two groups was noted only in the peripheral region of regenerating liver tissue. A marked depression was observed on post-operative day 2 in the MTC group, 433 +/- 50 dpm/micrograms DNA as compared to 782 +/- 111 dpm/micrograms DNA in the simple ligation group, and also in respect of protein synthesis and labeling index. Administration of FDP prior to operation brought about a complete inhibition of the serum LDH elevation. DNA synthesis was significantly enhanced in the peripheral region of regenerating liver tissue in rats pretreated with FDP (422 +/- 52, 783 +/- 112 and 912 +/- 115 dpm/micrograms DNA in the saline, FDP 0.25 mmol/kg and FDP 0.8 mmol/kg groups, respectively). Similar trends were observed as to protein synthesis and labeling index. FDP has been proven to be effective on protection of the liver cells as well as on promotion of the liver regeneration following hepatic resection by MTC.

Animals↗
PubMed1985

Pharmacokinetics and pharmacodynamics of d-tubocurarine and metocurine in the elderly.

The effects of age (older than 70 yr) on the pharmacokinetics and pharmacodynamics of d-tubocurarine (dTc) and metocurine (MTc) were evaluated in studies of 21 patients aged 70-87 and 21 patients aged 29-59. There was a significant difference in the pharmacokinetic parameters of all elderly patients compared with younger controls. With both dTc and MTc, the elderly exhibited a decreased plasma clearance, decreased initial volume of distribution, decreased volume of distribution, and a prolonged elimination half-life. After 0.3 mg/kg of dTc, the times for 50% return of twitch and recovery index (25-75% return of twitch response) in the elderly were significantly longer than in the young (P less than 0.02). A similar observation was made for the elderly patients receiving 0.15 mg/kg of MTc. No significant difference was seen in the log plasma concentration-twitch response relationship between 20-80% paralysis in young and in elderly patients receiving dTc. There was a similar lack of significant difference between the log plasma concentration-twitch response lines for elderly and young patients receiving MTc. Because there was no difference between the plasma concentration-response relationships in the elderly and young, altered sensitivity to dTc or MTc cannot explain the longer duration of action seen in the elderly. The most likely explanation for this difference is the altered pharmacokinetics of these two drugs in the elderly.

Adult↗
PubMed1983

[Differential diagnosis of basalioma and metatypical skin cancer].

The WHO histological classification of skin tumors (Geneva, 1980) has first distinguished a new nosologic variety of skin carcinoma, metatypic carcinoma (MTC) being intermediate between basalioma and squamous cell carcinoma. Separation of MTC from the group of basaliomas is important prognostically because this tumor is capable of metastasizing, whereas MTC diagnosis is difficult because it simulates basalioma clinically and morphologically. The study of the mitotic regimen in 13 cases of MTC and 20 cases of basalioma showed this method to be adequate for differential diagnosis of these tumors. The values of the mitotic regimen in MTC always differed from similar values in basalioma: the mitotic activity, the specific content of dividing cells at the stage of metaphase, and the rate of pathologic mitoses increased considerably, there appeared multipolar and monocentric mitoses, bridges, three-phase metaphases.

Aged↗
PubMed1982

Metastatic medullary thyroid carcinoma in young children with mucosal neuroma syndrome.

Multiple endocrine neoplasia, type 2b (MEN 2b) is a disorder characterized by a distinct phenotype and a predisposition for medullary thyroid carcinoma (MTC) and pheochromocytoma. Two siblings aged 3 and 6 years with MEN 2b, who had elevated plasma calcitonin levels suggesting the presence of MTC are described. Microscopic foci of MTC were found in their thyroid glands and the glands were removed. In the younger child, a metastatic focus was present in a cervical lymph node. Of 12 previously reported children with MEN 2b and MTC who were less than 10 years of age at diagnosis, five had metastases. One of the present patients is the youngest described with this complication. The high frequency of metastases in very young patients with this syndrome has not been emphasized previously. These findings indicate the need for early diagnosis of MEN 2b and the importance of thyroidectomy at the earliest possible age when MTC is suspected by calcitonin screening tests.

Adult↗
PubMed1993

Prevalence of pheochromocytoma and hyperparathyroidism in multiple endocrine neoplasia type 2A: results of long-term follow-up.

BACKGROUND: Multiple endocrine neoplasia type 2A (MEN 2A) is an autosomal dominant condition in which virtually all affected kindred members have medullary thyroid carcinoma (MTC). However, the penetrance of pheochromocytoma and hyperparathyroidism in affected kindred members is variable, and the true prevalence of these neoplasms is unclear from previous studies. METHODS: Members of MEN 2A kindreds with more than 10 years of follow-up screening for MTC, pheochromocytoma, or hyperparathyroidism were studied. The diagnosis of pheochromocytoma was based on histologic examination and hyperparathyroidism on both parathyroid hyperplasia plus preoperative elevation of serum calcium levels. RESULTS: Eighty-six patients operated on for MTC from 12 different MEN 2A kindreds were studied, with a mean follow-up of 12.9 years of screening for pheochromocytoma (79 patients) and 15.0 years for hyperparathyroidism (78 patients). Pheochromocytomas developed in 42% of patients with MTC, with a range of 6% to 100% in different kindreds. The prevalence of hyperparathyroidism was 35%, ranging from 0% to 53% between kindreds. The average age at diagnosis of MTC, pheochromocytoma, and hyperparathyroidism was 29, 37, and 36 years, respectively. CONCLUSIONS: We conclude that the penetrance of pheochromocytoma and hyperparathyroidism is variable in different kindreds with MEN 2A but that the overall prevalence of pheochromocytoma approximates 40% and that of hyperparathyroidism 35%.

Adolescent↗
PubMedDate not supplied

[Estimation of the rate of mother-to-child HIV transmission: methodological problems and current estimates. Report of 2 study workshops (Ghent, Belgium, 17-20 February 1992 and 3-5 September 1993).The International Study Group on mother-child transmission of HIV].

In the last eight years, numerous cohort studies have been conducted to estimate the rate of mother-to-child (MTC) transmission of HIV. Many of these have faced problems in data collection and analysis. This made it difficult to compare transmission rates (TRs) between studies. Two workshops on methodological aspects of the study of MTC transmission of HIV-1 were held in Ghent (Belgium) in February 1992 and September 1993. Fourteen teams of investigators participated, representing studies from Central (5) and Eastern Africa (3), Europe (2), Haiti (1) and the USA (3). A critical evaluation of the projects was carried out, under four headings: 1) enrollment and follow-up procedures, 2) diagnostic criteria and case definitions, 3) measurement and comparison of MTC TRs and 4) determinants of transmission. Reported TRs ranged from 13 to 32% in industrialized countries and from 25 to 48% in developing countries. However, no direct comparisons could be made because methods of calculation differed from study to study. Based on this review, a common methodology was developed during the 1992 workshop. Agreement was reached on definitions of HIV-related signs/symptoms, paediatric Aids and HIV-related deaths. A classification system of children born to HIV-1 infected mothers according to their probable HIV infection status during the first 15 months of life allowed the elaboration of a direct method of computation of the TR and of an indirect method for studies with a comparison group of children born to HIV-seronegative mothers. This standardized approach was subsequently applied to selected data sets to update previous estimates and provide a comparison of the MTC TRs of HIV-1 in 13 different settings. TRs were calculated during the 1993 workshop by the participating teams, using the direct and indirect methods. TRs based on the intermediate estimate obtained with the direct method ranged between 12.7 and 42.1%. Estimates of TRs obtained with the indirect method ranged from 20.7 to 42.8%. TRs observed in developed countries ranged from 14 to 25% with the direct method. In the developing world, these rates ranged from 13 to 42% with the direct method, from 21 to 43% with the indirect method and most of the studies reported a TR in the range of 25 to 30%. In general, both methods provide a reasonable estimate of the true TR. The risk of MTC transmission of HIV-1 tends to be higher in children born to HIV-seropositive mothers in Africa than in Europe.(ABSTRACT TRUNCATED AT 400 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1993

Somatostatin receptor scintigraphy and magnetic resonance imaging in recurrent medullary thyroid carcinoma: a comparative study.

In a prospective study, 18 patients with recurrent medullary thyroid carcinoma (MTC) underwent magnetic resonance imaging (MRI) of the neck and mediastinum and somatostatin receptor scintigraphy (SRS) with 111In-labeled pentetreotide. In nine patients with macroscopic MTC, 17 corresponding lesions were found on MRI and SRS; in addition, 13 suspicious lesions were seen on SRS only. Histological confirmation was available for 19 metastatic lesions, showing MRI to be true positive in 13 metastases, SRS in 18. In minimal residual disease (n = 10), MRI and SRS were compared with the histological findings in three patients and with selective venous catheterization (SVC) in seven patients. Corresponding findings on MRI and SVC were seen in one of seven, whereas SRS and SVC showed concordant localization of tumor recurrence in five of seven. Histological examination demonstrated MTC tissue in one of three cases; MRI and SRS were false positive in one of three cases, while in the others the interpretation remained uncertain. In conclusion, SRS is a promising imaging modality for localization of MTC recurrence. MRI provides better spatial resolution and thus facilitates the planning of surgery for macroscopic metastases. In minimal residual disease, SRS turned out to be superior in detecting occult MTC recurrence, confirming SVC findings.

Adolescent↗
PubMed1993

DNA analysis and persistent hypercalcitoninemia in medullary thyroid carcinoma.

The clinical data of 20 patients with medullary thyroid carcinoma (MTC) treated in Veterans General Hospital (VGH)-Taipei from 1970 to 1991 were reviewed. DNA content of the MTC and postoperative serum calcitonin (CT) were compared to evaluate patients' survival. All three patients with stage IV disease had aneuploid DNA and died within 7 months. The average survival was 4 months. The other 17 patients were all alive at the time of study and the mean follow up was 86 months. Three (3/7) patients had less than total thyroidectomy while only 2 (2/13) of the total thyoidectomized patients needed reoperation because of tumor recurrence. Of the 15 patients with available calcitonin data 11 had persistent post-operative hypercalcitoninemia. Among these 11 patients 5 out of the 6 patients with demonstrable lesions received reoperation; the other five (5/11) without demonstrable lesions were not operated and lived well in spite of persistent hypercalcitoninemia. One in 4 diploid patients and 9 in 12 aneuploid patients had metastatic lesions. No statistical significant correlation was found between the DNA content and survival, metastases or hypercalcitoninemia, although aneuploid MTC tended to be more advanced. We therefore concluded that total thyroidectomy is the treatment of choice for MTC. Persistent postoperative hypercalcitoninemia without clinical demonstrable lesions can be treated conservatively and DNA aneuploidy cannot be used as a reliable indicator of the grade of malignancy for MTC.

Adolescent↗
PubMed1993

Multiple breakpoints within the BCL-1 locus in B-cell lymphoma: rearrangements of the cyclin D1 gene.

Centrocytic lymphoma (CC) and intermediately differentiated lymphocytic lymphoma (IDL) are B-cell non-Hodgkin's lymphomas composed of lymphocytes presumably derived from follicle mantle cells. In these lymphomas, a specific chromosomal translocation, t(11;14)(q13;q32), has been described. Previous studies suggested an association between t(11;14) chromosomal translocations and BCL-1 rearrangements. To evaluate the association between BCL-1 rearrangements and CC/IDL, Southern blot analysis was performed on a panel of 20 cases of CC/IDL, 22 cases of morphologically similar non-Hodgkin's lymphomas, 11 cases of chronic B-cell leukemias, and 2 cases of myelomas. We used various probes covering a considerable proportion of the 120-kilobase BCL-1 locus, and rearrangements in 50% of CC/IDL (10 of 20) were detected. In CC, all 4 breakpoints were located at the major translocation cluster (MTC). In contrast, in IDL, rearrangements were detected in 3 different cluster regions: 2 cases in the MTC, 2 cases with a breakpoint 24 kilobases outside the MTC, and 2 additional cases with breakpoints found 3 kilobases 5' of the first exon of the PRAD1/CCND1 gene, which is located 120 kilobases outside the MTC. In addition, one leukemia showed a breakpoint 63 kilobases outside the MTC. In all cases, there was comigration of the rearranged 11q13 fragment and the immunoglobulin heavy chain-joining gene complex, indicating a t(11;14)(q13;q32) chromosomal rearrangement. Our results show that Southern blot analysis is helpful to identify CC/IDL, but multiple breakpoints are present over a large region, and therefore, many probes are necessary to cover all breakpoints.

Chromosome Mapping↗
PubMed1993

Chromosome t(11;14)(q13;q32) breakpoints in centrocytic lymphoma are highly localized at the bcl-1 major translocation cluster.

Chromosome 11q13 translocation breakpoints have been found dispersed over more than 100 kb of genomic DNA in centrocytic lymphoma and lymphocytic lymphoma of intermediate differentiation (mantle cell lymphoma). Approximately one-half of these translocations occur at the bcl-1 major translocation cluster (MTC) and appear tightly clustered by Southern blot restriction mapping. In order to specifically characterize these t(11;14)(q13;q32) translocations, six cases of centrocytic lymphoma with MTC rearrangements on Southern blot were studied. Genomic DNA was amplified by PCR (polymerase chain reaction) using a consensus immunoglobulin heavy-chain joining gene (JH) primer and two separate MTC primers. Sequencing of the PCR products revealed the MTC breakpoints in all six cases to be clustered within a 61 basepair span, very similar to those previously reported in t(11;14)-containing human B-cell lines. No two breakpoints were identical. JH breakpoints involved JH4 in five cases and JH6 in the other. Tight clustering of the MTC breakpoints thus permits PCR detection of the t(11;14) in many cases of centrocytic lymphoma, which may be of value in classifying this subtype of non-Hodgkin's lymphoma.

Base Sequence↗
PubMedDate not supplied

A randomized, double-blind, cross-over study comparing a levosulpiride-based and a metoclopramide-based combination in the prevention of ProMECE-CytaBOM-induced emesis.

BACKGROUND: To test two different antiemetic regimens for preventing nausea and vomiting in patient with non-Hodgkin's lymphoma (NHL) undergoing systemic chemotherapy (CT) with ProMECE-CytaBOM (P-C). PATIENTS AND METHODS: Twenty consecutive untreated adult outpatients with histologically confirmed NHL and scheduled to receive P-C chemotherapy were registered in a randomized, double-blind, cross-over study to compare the antiemetic efficacy of a levosulpiride (LS)-based and metoclopramide (MTC)-based regimen. RESULTS: Complete protection from vomiting was recorded in 93% (62/67) of courses with the LS-regimen and in 89% (62/70) with the MTC-regimen (p = 0.428). No nausea was observed in 84% (56/67) of courses with the LS-regimen and in 74% (52/70) with the MTC-regimen (p = 0.183). No differences in prevention of emesis were recorded when patients crossed to the other regimen. Both regimens were well tolerated; however, on day 8 of chemotherapy, when both antiemetic regimens were administered at a higher dose, the LS-based combination showed significantly lower toxicity (p = 0.035). CONCLUSIONS: ProMECE-CytaBOM-induced emesis can be prevented in most cases with appropriate, specifically designed antiemetic therapy. Both the LS- and MTC-based combinations resulted in a high percentage of complete protection from emesis, but the higher incidence of side effects observed with MTC makes the LS-based regimen preferable for patients receiving P-C chemotherapy.

Adult↗
PubMed1996

[Expression of the MDR1 gene in five human cell lines of medullary thyroid cancer and reversion of the resistance to doxorubicine by ciclosporin A and verapamil].

Medullary thyroid carcinoma (MTC) is frequently resistant to chemotherapy. Multidrug resistance (MDR) is one of the involved mechanisms. In this work we have studied the MDR1 gene expression in five MTC human cell lines that we have isolated and we have compared this expression to that of normal thyroid tissue. We have also tried to reverse the resistance to doxorubicin with verapamil (VRP) and ciclosporin A (CSA). MDR1 ARNm expression was studied and quantified by polymerase chain reaction (PCR) in normal and pathological thyroid tissues. The doxorubicin-induced cytotoxicity was evaluated with the 3,-4,5 dimethylthiazol-2,5 diphenyl tetrazolium bromide (MTT) test, the neutral red (NR) uptake and with total glutathione (GSH) or intracellular lactate dehydrogenase (LDH) measurements. We found an increase of MDR1 ARNm in MTC as compared with normal tissues. Doxorubicin was cytotoxic after a 48-h coincubation with the cells. Three microM CSA and 10 microM VRP reversed the doxorubicin resistance only after a 48-h coincubation, generally followed with a 24 h-post-incubation. In these conditions, the GSH levels were decreased only by VRP in all the five cell lines. In conclusion, a chemoresistance related to the MDR1 gene overexpression was found in the five human MTC lines tested. VRP and CSA reversed the resistance to doxorubicin in all the MTC cell lines tested.

Antineoplastic Agents↗
PubMed1996

Clinical experience of medullary thyroid carcinoma in Chang Gung Memorial Hospital.

Total 19 cases of medullary thyroid carcinoma (MTC) diagnosed at Chang Gung Memorial Hospital from Jan. 1979 to Dec. 1994 were studied retrospectively. All of them were pathologically proved. All cases except one were thought as sporadic MTC. The gender distribution showed a female preference with female : male (F:M) ratio of 3.8:1. The mean age at diagnosis was 44.9 +/- 13.7 years. The most common clinical presentation was thyroid mass in all (100%). The staging of MTC in our cases demonstrated: 12 (63%) stage I, 1 (5%) stage II, 3 (16%) stage III, and 3 (16%) stage IV. Thyroid ultrasonography with fine-needle aspiration cytology (FNAC) were performed in 15 patients. Eleven cases were diagnosed as malignancy, including 5 cases diagnosed as MTC preoperatively. Neck nodal metastases were noted in 7 cases and all occurred in tumors larger than 3 cm. All cases received operation according to clinical stage. Six of 7 patients who had preoperative calcitonin data showed abnormal high values. After operation, there were 8 patients with persistent hypercalcitoninemia. Of these, 5 received 131I therapy which induced undetectable calcitonin level in 2 stage I patients. Three cases received external beam radiotherapy but all failed. During a period of 0.5 to 9.4 years follow-up (mean +/- SE: 3.6 +/- 0.7 years), 3 patients died of pulmonary infection, 1 lost follow-up and 15 patients are alive and well. In conclusion, the preliminary data suggests that the medullary thyroid carcinoma in Taiwan has following characteristics: (1) gender distribution showed a female preference; (2) accuracy of preoperative FNAC was 42%; (3) most of the diagnoses of MTC were made postoperatively.

Adult↗
PubMed1996

Bispecific antibody and iodine-131-labeled bivalent hapten dosimetry in patients with medullary thyroid or small-cell lung cancer.

UNLABELLED: The purpose of this study was to estimate the dose delivered to tumor targets and normal tissues after two-step injection of an anti-CEA/anti-DTPA-In (F6-734) bispecific antibody and a 131I-labeled di-DTPA in-TL bivalent hapten in patients with medullary thyroid carcinoma (MTC) and small-cell lung cancer (SCLC). METHODS: Five patients with persistent disease or recurrences of MTC and five patients with primary SCLC or relapse were studied. In a first step, 0.1 to 0.3 mg/kg of F6-734 bispecific antibody was injected intravenously. Four days later, 6 nmole (5.8 to 9.8 mCi) of 131I-labeled di-DTPA in-TL bivalent hapten were injected. Quantitative imaging was performed during one week after the second injection. RESULTS: All 5 patients with MTC showed positive immunoscintigraphy (IS). In the smallest visualized and resected tumor (0.8 g), the fraction of injected activity per gram (% ID/g) was 0.1% at Day 3. IS was positive in 4 of the 5 patients with SCLC. The volume of the smallest visualized SCLC tumor was estimated at 11 +/- 2 ml, and tumor uptake was about 0.009% ID/g. Tumor dose estimates ranged from 4.2 to 174 cGy/mCi in patients with MTC and from 1.7 to 8 cGy/mCi in patients with SCLC. CONCLUSION: High absorbed dose values were calculated for small MTC recurrences. For SCLC recurrences the values were smaller but in the same range as those obtained by other investigators with the one-step technique in lymphoma.

Antibodies, Bispecific↗
PubMed1996

The relationship between specific RET proto-oncogene mutations and disease phenotype in multiple endocrine neoplasia type 2. International RET mutation consortium analysis.

OBJECTIVE: Multiple endocrine neoplasia type 2 (MEN 2) is an autosomal dominant disorder. The 3 recognized subtypes include MEN 2A, characterized by medullary thyroid carcinoma (MTC), pheochromocytoma (pheo), and hyperparathyroidism (HPT); MEN 2B, by MTC, pheo, and characteristic stigmata; and familial MTC (FMTC), by the presence of MTC only. The purpose of this study was to establish the relationship between specific mutations and the presence of certain disease features in MEN 2 which could help in clinical decision making. DESIGN: Correlative survey study of 477 MEN 2 families. SETTING: Eighteen tertiary referral centers worldwide. PATIENTS: A total of 477 independent MEN 2 families. MAIN OUTCOME MEASURES: Association between the position and type of germline mutation in the RET proto-oncogene and the presence or absence of MTC, pheo, HPT, and/or other features in a family. RESULTS: There is a statistically significant association between the presence of any mutation at a specific position (codon 634) and the presence of pheo and HPT. The presence of a specific mutation, CGC at codon 634, has yet to be associated with FMTC. Conversely, mutations at codons 768 and 804 are thus far seen only with FMTC, while codon 918 mutation is MEN 2B--specific. Rare families with both MEN 2 and Hirschsprung disease were found to have MEN 2-specific codon mutations. Patients with Hirschsprung disease presenting with such mutations should be monitored for the possible development of MEN 2 tumors. CONCLUSIONS: This consortium analysis suggests that genotype-phenotype correlations do exist and, if made reliably absolute, could prove useful in the future in clinical management with respect to screening, surveillance, and prophylaxis, as well as provide insight into the genetic effects of particular mutations.

Carcinoma, Medullary↗
PubMed1997

Technetium-99m-sestamibi scanning in recurrent medullary thyroid carcinoma.

UNLABELLED: The presence of recurrent medullary thyroid carcinoma (MTC) can be detected early by measurement of serum calcitonin levels, but the localization of recurrent tumors is often difficult. METHODS: We compared 99mTc-sestamibi scans with computed tomographic (CT) scans in 10 patients with recurrent MTC, who had basal serum calcitonin values ranging from 220-61800 ng/liter. Two patients additionally had bone scans performed because of the clinical suspicion of bone metastases. RESULTS: Seven of the 10 patients had at least one site of abnormal 99mTc-sestamibi uptake, and all of these patients had basal serum calcitonin values > 6000 ng/liter. Only five of the 10 patients had abnormal CT scans. Technetium-99m-sestamibi scans detected 22 abnormal sites in the soft tissues of the neck and chest, while CT scans detected only 11 lesions in the neck and chest. Five of these sestamibi positive sites (in the neck and mediastinum of one patient) were confirmed histologically to represent MTC. When imaging the liver, CT scans detected 47 lesions in three patients while 99mTc-sestamibi scans detected none. One of these liver lesions was confirmed as MTC histologically. When imaging bone in two of the patients, the bone scans detected 17 abnormal sites, while 99mTc-sestamibi scans detected six abnormal sites. CONCLUSION: Technetium-99m-sestamibi scans complement CT and bone scans in the localization of recurrent MTC in patients with extremely high calcitonin levels. Technetium-99m-sestamibi scans are more sensitive than CT scans in the assessment of the soft tissues of the neck and chest, but CT is more appropriate for imaging hepatic lesions and bone scans are better for imaging bone lesions. Technetium-99m-sestamibi scans are unlikely to be abnormal in patients with only mild elevation of calcitonin.

Adult↗
PubMed1997

A spectrum of cytomorphologic variations in medullary thyroid carcinoma. Fine-needle aspiration findings in 19 cases.

BACKGROUND: Medullary thyroid carcinoma (MTC), a rare malignancy with a variety of morphologic appearances, can mimic both primary and metastatic lesions of the thyroid gland and give rise to diagnostic problems when these tumors are aspirated. Although cytopathologic features of MTC have been well described, this study was undertaken to define and elaborate further, subtle morphologic variations, the recognition of which would be helpful in the diagnosis of MTC. METHODS: A retrospective review of 19 cases of histologically confirmed MTC was conducted. Fine-needle aspirations were performed by endocrinologists or cytopathologists using a 23- or 25-gauge needle. Smears were stained with Diff-Quik, Papanicolaou, or hematoxylin and eosin (H&E) stain. Cell blocks were routinely prepared, and 4-micron sections were stained with H&E. RESULTS: Certain cytologic features, such as eccentric nuclei, neuroendocrinelike nuclei, inconspicuous nucleoli, binucleation and multinucleation, ill-defined cytoplasmic borders, and a clean background, were present in all cases. Additional helpful features seen in some but not in all cases included syncytial groups of cells, round to oval and spindle shapes, dendritic cell processes, the presence of amyloid, and nuclear molding and grooves. CONCLUSIONS: The authors found that MTC could be adequately diagnosed by fine-needle aspiration, despite the frequent cytomorphologic variations, based on a set of features consistently present in all the cases included in this study. Features such as neuroendocrinelike chromatin and nuclear molding have not been previously described.

Biopsy, Needle↗
PubMed1997

Somatostatin receptor scintigraphy in medullary thyroid carcinoma.

BACKGROUND: 111In-radiolabelled (DTPA-D-Phe1)-octreotide scintigraphy can be used to localize neuroendocrine tumours expressing somatostatin receptors (SSTRs). The aim of this paper was to analyse the importance of tumour volume and growth for the visualization by SSTR scintigraphy of metastases from medullary thyroid carcinoma (MTC). METHODS: Serum calcitonin concentrations were used to estimate volume and growth rate of MTC. Twenty-two patients who had persistent hypercalcitoninaemia after total thyroidectomy for MTC, indicating the presence of metastases, were studied. RESULTS: SSTR scintigraphy visualized 15 tumours in 11 patients. Patients with scintigraphically visualized tumours had higher serum calcitonin and carcinoembryonic antigen concentrations and larger tumours, and the serum calcitonin concentration increased more rapidly with time. Tumour-associated symptoms and death from MTC occurred only in patients with scintigraphically visualized tumours. CONCLUSION: Scintigraphically visualized tumours grow more rapidly and are more aggressive than nonvisualized lesions. SSTR scintigraphy can be helpful in the planning of palliative surgery for MTC and for diagnosing distant metastases, but cannot localize microscopic metastases.

Blotting, Northern↗