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CASE REPORT
Year : 2012  |  Volume : 9  |  Issue : 2  |  Page : 60-63

Spindle cell variant of medullary carcinoma of thyroid with nodal metastasis: Cytodiagnosis and diagnostic dilemma


1 Department of Pathology, Medical College, Kolkata, India
2 Department of Pathology, Malda Medical College, West Bengal, India

Correspondence Address:
Santosh Kumar Mondal
Teenkanya Complex, Flat 1B, Block B, 204 R N Guha Road, Dumdum, Kolkata- 700 028, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-0354.96057

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A 45-year-old female presented with a thyroid nodule on right lobe since 2 years and an enlarged cervical lymph node for past 6 months. Fine needle aspirations were done from the thyroid nodule. Fine needle aspiration cytology from thyroid swelling revealed discretely arranged elongated spindle-shaped cells with scant cytoplasm. Clumps of glassy pink amyloid-like material were noted in the background on air-dried smears. A provisional cytodiagnosis of spindle cell variant of medullary carcinoma of thyroid (MCT) was made based on cytomorphology. But diagnostic dilemma appeared as spindle cell tumor might mimic fibroblasts from supporting stroma, melanoma, or even anaplastic carcinoma. Distinction of amyloid from hyaline collagen or basement membrane material was also difficult on cytologic smears. Subsequently, serum calcitonin measurement and histopathological examination confirmed the case to be spindle cell variant of MCT with nodal metastasis.


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