Occult sporadic medullary microcarcinoma with lymph node metastases

A sporadic form of medullary occult microcarcinoma was cytologically diagno sed, by fine-needle aspiration biopsy (FNAB), an metastatic cervical lymph nodes. The cytologic specimens were partially smeared and partially zinc-fo rmalin-fixed, so that microinclusion clot for immunohistochemical studies w ould be possible. The reactivity to calcitonin of neoplastic cells obtained from metastatic cervical lymph nodes supported the search for a thyroid tu mor, which only a careful echographic study revealed. Under sonographic guidance, FNAB on a 0.5-cm hypoechoid nodule was performe d. The smears were diagnostic of medullary carcinoma. A total thyroidectomy with node dissection was made. Diagn, Cytopathol. 1999;21:203-206. (C) 199 9 Wiley-Liss, Inc.