Medullary carcinoma of the thyroid

Immunohistochemistry

calcitonin	most cases
chromogranin	positive
CEA	88-100%
Cytokeratin 5/6	0/164, 0%5
Cytokeratin 7	15/164, 100%5
Cytokeratin 14	0/164, 0%5
Cytokeratin 19	positive
Cytokeratin 20	0/174, 0%5
Galactin-3	3/62, 16/20 (7 weak/focal, 7 moderate, 2 strong)3, 1/2
calcitonin-gene related peptide	variable
somatostatin	variable
ACTH	variable
endorphin	variable
serotonin	variable
gastrin	variable
histaminase	variable
bombesin	variable
gastrin-releasing peptide	variable

S-100 stains sustentacular cells, which are present in may (63%) MEN-associated medullary carcinomas but are uncommon in sporadic tumours (9%).

Positivity for CEA supports a diagnosis of medullary carcinoma even in the absence of calcitonin immunoreactivity in the setting of familial medullary carcinoma or MEN.

References

Diagnostic histopathology of tumors. Edited by CDM Fletcher. 2nd edition. Churchill Livingstone. Page 1008.

²Fernandez, P.L., Merino, M.J., Gomez, M., Campo, E., Medina, T., Castronovo, V., Sanjuan, X., Cardesa, A., Liu, F.T. and Sobel, M.E. Galectin-3 and laminin expression in neoplastic and non-neoplastic thyroid tissue. J Pathol 1997;181:80-6.

³Cvejic, D., Savin, S., Paunovic, I., Tatic, S., Havelka, M. and Sinadinovic, J. Immunohistochemical localization of galectin-3 in malignant and benign human thyroid tissue. Anticancer Res 1998;18:2637-41.

⁴Chu, P. G. and L. M. Weiss (2002). "Keratin expression in human tissues and neoplasms." Histopathology 40(5): 403-39. (Summary data from multiple papers)

⁵Erickson, L. A. and R. V. Lloyd (2004). "Practical markers used in the diagnosis of endocrine tumors." Adv Anat Pathol 11(4): 175-89.

This page last revised 21.7,2004.

©SMUHT/PW Bishop