Modified Fine-Needle Aspiration Biopsy for Calcitonin, Procalcitonin and Carcinoembryonic Antigen Levels in the Diagnosis of Thyroid Nodules With Medullary Thyroid Carcinoma

Mohamed K. M. Shakir, Thanh D. Hoang, Diane U. Elegino-Steffens, Vinh Q. Mai, Patrick W. Clyde


Background: The diagnostic tests have low sensitivities in detecting medullary thyroid cancer (MTC). We describe a modified fine-needle thyroid nodule biopsy (MFNB) technique that improved the diagnostic accuracy. MFNB was performed in three patients with MTC.

Methods and results: A 41-year-old female presented with thyroid nodules and a family history of MTC. Fine-needle biopsy (FNB) of the thyroid nodules showed non-confirmatory cytology. MFNB established cytology more confirmatory of MTC. Additionally, intravenous administration of calcium-stimulated serum concentrations of procalcitonin (PCt) level, in addition to calcitonin (Ct) and MFNB, also confirmed elevated levels of Ct, PCt, and carcinoembryonic antigen (CEA) in the aspirate samples. The diagnosis of MTC was finally confirmed histologically after thyroidectomy. A 54-year-old female presented to our clinic for evaluation of a right thyroid nodule. An MFNB compared to standard FNB showed a more confirmatory MTC cytology along with markedly elevated levels of Ct, PCt, and CEA in the aspirated samples by the MFNB technique. Additionally, intravenous calcium administration increased PCt serum concentrations. The diagnosis of MTC was confirmed after surgery. A 65-year-old female reported to our clinic with a diagnosis of multinodular goiter and a family history of thyroid cancer. FNB showed atypical cells, although MFNB was more confirmatory for diagnosing MTC. Elevated serum PCt levels were also seen with calcium stimulation and MFNB aspirate samples also confirmed elevated levels of Ct, PCt, and CEA. MFNB of nodules in three patients with surgically confirmed benign thyroid confirmed low levels of Ct, PCt and CEA levels in the aspirate samples. Similar findings were confirmed in a patient with papillary thyroid cancer.

Conclusion: MFNB was more confirmatory for diagnosing MTC than conventional FNB. Determining Ct, PCt, and CEA levels in MFNB aspirate samples may improve the diagnostic accuracy.

J Endocrinol Metab. 2017;7(1):5-17


Fine-needle biopsy; Calcitonin; Procalcitonin; Carcinoembryonic antigen; Thyroid nodules; Medullary thyroid carcinoma; Calcium stimulation

Full Text: HTML PDF
Home     |     Log In     |      About     |      Search     |      Current     |      Archives     |      Submit      |     Subscribe



Aims and Scope

Current Issues

Conflict of Interest

About Publisher

Editorial Board



Company Profile

Editorial Office

Misconduct and Retraction


Company Registration

Contact Us

Abstracting and Indexing



Instructions to Authors


Declaration of Helsinki

Contact Publisher

Submission Checklist


Terms of Use

Company Address

Submit a Manuscript

Open Access Policy

Privacy Policy

Browse Journals

Publishing Fee

Publishing Policy


Recent Highlights

Peer-Review Process

Publishing Quality

Code of Ethics

Advertising Policy

Manuscript Tracking

Advanced Search

For Librarians


Publishing Process

Publication Frequency

For Reviewers

Propose a New Journal


Journal of Endocrinology and Metabolism, bimonthly, ISSN 1923-2861 (print), 1923-287X (online), published by Elmer Press Inc.        
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)

This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website:   editorial contact:
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.