Desmoplasia in medullary thyroid carcinoma: a reliable indicator of metastatic potential.
OBJECTIVE
To evaluate the reliability of desmoplasia as a reproducible morphological parameter indicating the metastatic potential of medullary thyroid carcinoma (MTC).


RESULTS
One hundred and twenty cases of MTC of the Medical University of Vienna, Austria and 76 cases from the School of Medicine of Marseille, France were analysed for the presence of desmoplastic stroma reaction by four endocrine pathologists. Intra- and interobserver concordance was assessed. The Austrian cases were also analysed for various morphological parameters. Intra- and interobserver concordance were highly significant with a kappa value of 0.883 for intra-observer reliability and 0.837, 0.79 and 0.758, respectively, when pathologists N.N., C.D.M. and K.W.S. reviewed the Austrian cases. The cases from France were reviewed by C.D.M. and K.K. with a kappa value of 0.759. None of the cases that were categorized as desmoplasia negative by any of the investigators showed lymph node metastasis. No other distinct morphological characteristics could be assigned to the MTCs without desmoplasia.


CONCLUSIONS
Our data indicate desmoplasia to be a reliable and highly reproducible parameter with regard to lymph node metastatic potential.
Koperek
O
O
Department of Clinical Pathology, Medical University of Vienna, Vienna, Austria.
Scheuba
C
C
Cherenko
M
M
Neuhold
N
N
De Micco
C
C
Schmid
K W
KW
Niederle
B
B
Kaserer
K
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018276:Carcinoma, Medullary / Q000175:diagnosis* / Q000378:metabolism / Q000556:secondary; D003094:Collagen; D005260:Female; D005355:Fibrosis; D006801:Humans; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D017154:Stromal Cells / Q000378:metabolism / Q000473:pathology; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000378:metabolism
D003094:Collagen