Immunocytochemistry and Immunohistochemistry on Liquid-Based Preparations of Thyroid FNA

  • Megha Joshi
  • Sumita Gokhale
  • Rana S. HodaEmail author


  • Immunocytohistochemistry/immunohistochemistry (ICC/IHC) has become an indispensable tool in the practice of surgical pathology and cytology. In our daily clinical practice, most specimens from thyroid fine needle aspiration (FNA) and liquid-based preparations (LBP) are diagnosed without the routine use of immunostain, but IHC can be used judiciously on the corresponding cell block in certain situations to confirm or rule out a diagnosis. Scraping of thick Diff-Quik (DQ)–stained smears into the CytoLyt/CytoRich Red (collection media for ThinPrep [TP] and SurePath [SP] respectively) at the time of rapid on-site evaluation (ROSE) to prepare the cell block can further enhance the yield, and multiple immunostains can be performed on the cell block if needed.


Immunocytochemistry Immunohistochemistry LBP Thyroid FNA CK19 HBME1 Galectin-3 Chromogranin Synaptophysin Papillary thyroid carcinoma Medullary thyroid carcinoma Lymphoma Anaplastic carcinoma Poorly differentiated carcinoma BRAF antibody 

Suggested Reading

  1. 1.
    Clark DP, Faquin WC. Thyroid cytopathology. 2nd ed. New York: Springer; 2010.CrossRefGoogle Scholar
  2. 2.
    Dabbs DJ, Abendroth CS, Grenko RT, Wang X, Radcliffe GE. Immunocytochemistry on the Thinprep processor. Diagn Cytopathol. 1997;17:388–92.CrossRefGoogle Scholar
  3. 3.
    Freitag CE, Schoenfield L, Nabhan FA, Naturale RT, Jin M. Fine-needle aspiration cytology of a thyroid nodule: challenging morphologic considerations. CytoJournal. 2019;16:5. Scholar
  4. 4.
    Khan A. Surgical pathology of endocrine and neuroendocrine tumors. 2009. ISBN 978-1-60327-395-4. Scholar
  5. 5.
    Kim JK, Seong CY, Bae IE, Yi JW, Yu HW, Kim SJ, et al. Comparison of immunohistochemistry and direct sequencing methods for identification of the BRAF(V600E) mutation in papillary thyroid carcinoma. Ann Surg Oncol. 2018;25:1775–81. Scholar
  6. 6.
    Leung SW, Bédard YC. Immunocytochemical staining on ThinPrep processed smears. Mod Pathol. 1996;9:304–6.PubMedGoogle Scholar
  7. 7.
    Liu H, Lin F. Application of immunohistochemistry in thyroid pathology. Arch Pathol Lab Med. 2015;139:67–82. Scholar
  8. 8.
    Pazaitou-Panayiotou K, Mygdakos N, Boglou K, Kiziridou A, Chrisoulidou A, Destouni C. The immunocytochemistry is a valuable tool in the diagnosis of papillary thyroid cancer in FNA’s using liquid-based cytology. J Oncol. 2010;2010:963926. Scholar
  9. 9.
    Pusztaszeri MP, Bongiovanni M, Faquin WC. Update on the cytologic and molecular features of medullary thyroid carcinoma. Adv Anat Pathol. 2014;21:26–35. Scholar
  10. 10.
    Rossi ED, Raffaelli M, Mulè A, Miraglia A, Lombardi CP, Vecchio FM, et al. Simultaneous immunohistochemical expression of HBME-1 and galectin-3 differentiates papillary carcinomas from hyperfunctioning lesions of the thyroid. Histopathology. 2006;48:795–800.CrossRefGoogle Scholar
  11. 11.
    Rossi ED, Raffaelli M, Mulè A, Zannoni GF, Pontecorvi A, Santeusanio G, et al. Relevance of immunocytochemistry on thin-layer cytology in thyroid lesions suspicious for medullary carcinoma: a case-control study. Appl Immunohistochem Mol Morphol. 2008;16:548–53. Scholar
  12. 12.
    Sapio MR, Guerra A, Posca D, Limone PP, Deandrea M, Motta M, et al. Combined analysis of galectin-3 and BRAFV600E improves the accuracy of fine-needle aspiration biopsy with cytological findings suspicious for papillary thyroid carcinoma. Endocr Relat Cancer. 2007;14:1089–97.CrossRefGoogle Scholar
  13. 13.
    Sconamiglio T, Hyjek E, Kao J, Chen YT. Diagnostic usefulness of HBME-1, galectin-3, CK19, CITED1 and evaluation of their expression in encapsulated lesions with questionable features of papillary thyroid carcinoma. Am J Clin Pathol. 2006;126:700–8.CrossRefGoogle Scholar
  14. 14.
    Song S, Kim H, Ahn SH. Role of immunohistochemistry in fine needle aspiration and core needle biopsy of thyroid nodules. Clin Exp Otorhinolaryngol. 2019;12:224–30. Scholar
  15. 15.
    Suzuki A, Hirokawa M, Takada N, Higuchi M, Ito A, Yanao N, et al. Fine needle aspiration cytology for medullary thyroid carcinoma: a single institutional experience in Japan. Endocr J. 2017;64:1099–104. Scholar
  16. 16.
    Tripathy K, Mishra A, Singh AK, Panda PL, Mahapatra A, Lenka A. Immunocytochemistry using liquid-based cytology: a tool in hormone receptor analysis of breast cancer. J Cytol. 2018;35:260–4. Scholar
  17. 17.
    Wuertz FG, Kresnik E, Malle P, Hyden M, Lind P, Rogatsch H, et al. Fine-needle aspiration with immunohistochemistry using a modified scrape cell block technique for the diagnosis of thyroid and parathyroid nodules. Acta Cytol. 2016;60:118–30. Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Winchester HospitalWinchesterUSA
  2. 2.Department of CytologyWinchester HospitalWinchesterUSA
  3. 3.CBLPathRye BrookUSA

Personalised recommendations