Revisiting the Significance of Prominent C Cells in the Thyroid

  • Talia L. Fuchs
  • Stephen E. Bell
  • A. Chou
  • Anthony J. GillEmail author


C cell hyperplasia is considered a precursor lesion for hereditary forms of medullary thyroid carcinoma. It has therefore been suggested as a morphological marker to distinguish hereditary from sporadic medullary thyroid carcinoma and to triage genetic testing in resource poor settings. However, numerous definitions for C cell hyperplasia have been suggested, and there is surprisingly little data regarding the number of C cells present in thyroid glands removed for conditions other than medullary carcinoma. We therefore sought to investigate the specificity of different criteria for C cell hyperplasia. We examined the number of C cells and solid cell nests (ultimobranchial body remnants) present in 118 completion thyroidectomy specimens from patients without medullary carcinoma and with no risk factors for MEN2. Morphological review was performed on all H&E-stained slides, and immunohistochemistry for calcitonin was performed on one block from each case. Solid cell nests were found in 4 (3.3%) of thyroids. Increased numbers of C cells sufficient to fulfil criteria for C cell hyperplasia were found in 5 (4.2%) to 36 (30.5%) cases depending on the criteria used. We conclude that large numbers of C cells are commonly found in thyroids not associated with medullary carcinoma. Therefore, regardless of which criteria are used, the presence of C cell hyperplasia is not a specific marker for hereditary medullary thyroid carcinoma.


Medullary thyroid carcinoma C cell hyperplasia MEN2 


Compliance with Ethical Standards

This study was approved by the local institutional ethics committee.

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Talia L. Fuchs
    • 1
    • 2
  • Stephen E. Bell
    • 1
  • A. Chou
    • 1
    • 2
    • 3
  • Anthony J. Gill
    • 1
    • 2
    • 3
    Email author
  1. 1.Cancer Diagnosis and Pathology GroupKolling Institute of Medical ResearchSt LeonardsAustralia
  2. 2.NSW Health Pathology, Department of Anatomical PathologyRoyal North Shore HospitalSt LeonardsAustralia
  3. 3.University of SydneySydneyAustralia

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