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General Surgery · Thyroid: medullary carcinoma
Sample itemA patient has a firm thyroid nodule, diarrhoea and a raised serum calcitonin. Biopsy shows polygonal cells in an amyloid stroma. Which cells give rise to this tumour?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Parafollicular C cells
Medullary carcinoma arises from parafollicular C cells, secretes calcitonin and CEA, and stains for amyloid. A quarter of cases are hereditary with RET mutation (MEN2). It does not take up radioiodine, so total thyroidectomy with central node dissection is the main treatment.
Option by option
A. Parafollicular C cells (correct)
Correct. C cells produce calcitonin and give rise to this tumour.
B. Follicular cells
Follicular cells give papillary and follicular carcinoma.
C. Oxyphil cells
Oxyphil cells relate to Hurthle cell and parathyroid lesions.
D. Lymphocytes
Lymphocytes give thyroid lymphoma.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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