The Korean Journal of Cytopathology (대한세포병리학회지)

The Korean Society for Cytopathology (대한세포병리학회)
권호 표지

Analysis of Fine Needle Aspiration Cytology and Ultrasonography of Metastatic Tumors to the Thyroid

갑상샘 전이종양에 대한 세침흡인 세포 소견과 초음파 소견의 분석

  • Cho, Eun-Yoon (Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Oh, Young-Lyun (Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 조은윤 (성균관대학교 의과대학 삼성서울병원, 병리과) ;
  • 오영륜 (성균관대학교 의과대학 삼성서울병원, 병리과)
  • Published : 2007.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Cytologic diagnosis of the metastatic tumors to the thyroid is important in the management of the patients. There have been rare reports analyzing fine-needle aspiration (FNA) cytology of metastatic tumors to the thyroid. This study examines comprehensive cytologic findings of metastatic tumors to the thyroid with radiologic findings. The FNA cytology slides obtained from 12 cases with metastatic tumors of the thyroid; lung cancer (n=5), tongue and tonsil cancer (n=3), esophageal cancer (n=2), and breast cancer (n=2) were reviewed. Radiological study showed single mass with heterogeneous texture or multiple masses without calcification. Metastatic tumor was easily considered in a differential diagnosis of FNA cytology because they had peculiar cytological features which were not seen in primary thyroid tumor. The smear background varied from predominantly necrotic, bloody, and inflammatory to colloid. The aspirates exhibited a mixture of benign follicular cells and malignant cells in 6 cases. The characteristic cytoplasmic features of the tumor cells, such as keratin, mucin and melanin, were found in 9 cases. Although some cases mimic primary thyroid neoplasm, a careful examination of the cytological characteristics may help cytopathologists to recognize a metastatic tumor in the thyroid by FNA, and may help the clinicians to establish a proper treatment plan.

Keywords

References

  1. Ericsson M, Biorklund A, Cederquist E, Ingemansson S, Akerman M. Surgical treatment of metastatic disease in the thyroid gland. J Surg Oncol 1981;17:15-23 https://doi.org/10.1002/jso.2930170104
  2. Nakhjavani MK, Gharib H, Goellner JR, van Heerden JA. Metastasis to the thyroid gland. A report of 43 cases. Cancer 1997;79:574-8 https://doi.org/10.1002/(SICI)1097-0142(19970201)79:3<574::AID-CNCR21>3.0.CO;2-#
  3. Watts NB. Carcinoma metastatic to the thyroid: prevalence and diagnosis by fine-needle aspiration cytology. Am J Med Sci 1987;293:13-7 https://doi.org/10.1097/00000441-198701000-00004
  4. Wood K, Vini L, Harmer C. Metastases to the thyroid gland: the Royal Marsden experience. Eur J Surg Oncol 2004;30:583-8 https://doi.org/10.1016/j.ejso.2004.03.012
  5. Chung SY, Kim EK, Kim JH, et al. Sonographic findings of metastatic disease to the thyroid. Yonsei Med J 2001;42:411-7 https://doi.org/10.3349/ymj.2001.42.4.411
  6. Nanni C, Rubello D, Fanti S, et al. Role of 18F-FDG-PET and PET/CT imaging in thyroid cancer. Biomed Pharmacother 2006;60:409-13 https://doi.org/10.1016/j.biopha.2006.07.008
  7. Jones AJ, Aitman TJ, Edmonds CJ, Burke M, Hudson E, Tellez M. Comparison of fine needle aspiration cytology, radioisotopic and ultrasound scanning in the management of thyroid nodules. Postgrad Med J 1990;66:914-7 https://doi.org/10.1136/pgmj.66.781.914
  8. Kim TY, Kim WB, Gong G, Hong SJ, Shong YK. Metastasis to the thyroid diagnosed by fine-needle aspiration biopsy. Clin Endocrinol (Oxf) 2005;62:236-41 https://doi.org/10.1111/j.1365-2265.2005.02206.x
  9. Lin JD, Weng HF, Ho YS. Clinical and pathological characteristics of secondary thyroid cancer. Thyroid 1998;8:149-53 https://doi.org/10.1089/thy.1998.8.149
  10. Michelow PM, Leiman G. Metastases to the thyroid gland: diagnosis by aspiration cytology. Diagn Cytopathol 1995;13:209-13 https://doi.org/10.1002/dc.2840130306
  11. Mirallie E, Rigaud J, Mathonnet M, et al. Management and prognosis of metastases to the thyroid gland. J Am Coll Surg 2005;200:203-7 https://doi.org/10.1016/j.jamcollsurg.2004.10.009
  12. Untch BR, Olson JA, Jr. Anaplastic thyroid carcinoma, thyroid lymphoma, and metastasis to thyroid. Surg Oncol Clin N Am 2006;15:661-79 https://doi.org/10.1016/j.soc.2006.05.006
  13. Kim S, Jin SY, Lee DW. Fine needle aspiration cytology of metastatic adenocarcinoma of the thyroid gland from the colon. Report of a case. Korean J Cytopathol 1994;5:41-5 https://doi.org/10.1111/j.1365-2303.1994.tb00126.x
  14. Fanning TV, Katz RL. Evaluation of thyroid nodules in cancer patients (letter). Acta Cytol 1986;30:572
  15. Shimaoka K, Sokal JE, Pickren JW. Metastatic neoplasms in the thyroid gland. pathological and clinical findings. Cancer 1962;15:557-65 https://doi.org/10.1002/1097-0142(196205/06)15:3<557::AID-CNCR2820150315>3.0.CO;2-H
  16. Silverberg SG VR. Metastatic tumors in the thyroid. Pacif Med Surg 1966;74:175-80
  17. McCabe DP, Farrar WB, Petkov TM, Finkelmeier W, O'Dwyer P, James A. Clinical and pathologic correlations in disease metastatic to the thyroid gland. Am J Surg 1985;150:519-23 https://doi.org/10.1016/0002-9610(85)90167-9
  18. Czech JM, Lichtor TR, Carney JA, van Heerden JA. Neoplasms metastatic to the thyroid gland. Surg Gynecol Obstet 1982;155:503-5
  19. Eftekhari F, Peuchot M. Thyroid metastases: combined role of ultrasonography and fine needle aspiration biopsy. J Gin Ultrasound 1989;17:657-60 https://doi.org/10.1002/jcu.1870170908
  20. Frates MC, Benson CB, Charboneau JW, et al. Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement. Ultrasound Q 2006;22:231-8; discussion 9-40 https://doi.org/10.1097/01.ruq.0000226877.19937.a1
  21. Kini S. Guidelines to clinical aspiration biopsy: thyroid. 1st ed ed. New York-Tokyo: Igaku-Shoin Medical Pub, 1987
  22. Dictor M, Tennvall J, Akerman M. Moderately differentiated neuroendocrine carcinoma (atypical carcinoid) of the supraglottic larynx. A report of two cases including immunohistochemistry and aspiration cytology. Arch Pathol Lab Med 1992;116:253-7
  23. Loo CK, Burchett IJ. Fine needle aspiration biopsy of neuroendocrine breast carcinoma metastatic to the thyroid. A case report. Acta Cytol 2003;47:83-7 https://doi.org/10.1159/000326480
  24. Guarda LA, Peterson CE, Hall W, Baskin HJ. Anaplastic thyroid carcinoma: cytomorphology and clinical implications of fine-needle aspiration. Diagn Cytopathol 1991;7:63-7 https://doi.org/10.1002/dc.2840070117
  25. Lam KY, Lo CY, Liu MC. Primary squamous cell carcinoma of the thyroid gland: an entity with aggressive clinical behaviour and distinctive cytokeratin expression profiles. Histopathology 2001;39:279-86 https://doi.org/10.1046/j.1365-2559.2001.01207.x
  26. Larson RS, Wick MR. Primary mucoepidermoid carcinoma of the thyroid: diagnosis by fine-needle aspiration biopsy. Diagn Cytopathol 1993;9:438-43 https://doi.org/10.1002/dc.2840090413
  27. Smith SA, Gharib H, Goellner JR. Fine-needle aspiration. Usefulness for diagnosis and management of metastatic carcinoma to the thyroid. Arch. Intern. Med 1987;147:311-2 https://doi.org/10.1001/archinte.147.2.311
  28. Aron M, Kapila K, Verma K. Role of fine-needle aspiration cytology in the diagnosis of secondary tumors of the thyroid--twenty years' experience. Diagn Cytopathol 2006;34:240-5 https://doi.org/10.1002/dc.20329