title: Detection of thyroglobulin in fine needle aspirates of nonthyroidal neck masses: a clue to the diagnosis of metastatic differentiated thyroid cancer.
abstract: We studied the feasibility of employing the measurement of thyroglobulin (Tg) in the washout of the needle used to perform the fine needle aspiration cytology (FNA-Tg) for the differential diagnosis of nonthyroidal neck masses of unknown etiology. We studied 35 patients presenting for 1 or more neck lumps outside the thyroid gland. A previous history of treated differentiated thyroid cancer (DTC) was given by 23 patients and of nonthyroidal malignancy by 3 patients. FNA-Tg was measured in the Tg-free serum used to wash out the needle employed for the cytology. Finally, all patients were treated by surgery. FNA-Tg was always detectable in 14 patients with thyroid cancer metastases demonstrated by histology, with a mean (+/- SD) of 27,087 +/- 37,622 ng/FNA (P less than 0.002) compared to patients without thyroid cancer metastases (mean +/- SD, 12.1 +/- 4.8 ng/FNA in 7 cases; undetectable in 14 cases). Assuming 21.7 ng/FNA (the mean +/- 2 SD of the negative patients) as the cut-off value, all patients with metastases from DTC were detected by FNA-Tg. FNA-Tg had better negative predictive value than cytology, since this last technique gave 10 inconclusive results, comprising 2 false negative results in patients with metastases from DTC. Our results indicate that elevated concentrations of FNA-Tg in nonthyroidal neck nodes strongly suggest the diagnosis of metastases from DTC.
authors.affiliation: Istituto di Endocrinologia, University of Pisa, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Pacini
authors.forename: L
authors.initials: L
authors.lastname: Fugazzola
authors.forename: F
authors.initials: F
authors.lastname: Lippi
authors.forename: C
authors.initials: C
authors.lastname: Ceccarelli
authors.forename: R
authors.initials: R
authors.lastname: Centoni
authors.forename: P
authors.initials: P
authors.lastname: Miccoli
authors.forename: R
authors.initials: R
authors.lastname: Elisei
authors.forename: A
authors.initials: A
authors.lastname: Pinchera
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis* / Q000097:blood; D001707:Biopsy, Needle; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D013954:Thyroglobulin / Q000032:analysis* / Q000097:blood; D013964:Thyroid Neoplasms / Q000097:blood / Q000175:diagnosis / Q000473:pathology* / Q000556:secondary
chemical_list: D014408:Biomarkers, Tumor; D013954:Thyroglobulin