Detection of cervical metastases of thyroid medullary carcinoma by MoAb anti-CEA scintigraphy and immunohistochemistry.

Four patients with medullary thyroid carcinoma (MTC) were examined using anti-carcinoembryonic antigen (CEA) scintigraphy. Two patients had positive and two normal scintigraphic findings, although all the patients had elevated blood test markers (calcitonin or CEA). One patient with clinical suspicion of MTC metastases had only a faintly positive anti-CEA image, although single-photon emission tomographic scanning was used to increase the sensitivity and resolution of the method. Therefore, digital image processing of the planar images was performed to obtain more detailed information. The analysis revealed distinct accumulation of the activity at the right side of the neck at 20 h post administration. The specificity of the antibody binding in the malignant cells was confirmed after surgery by immunohistochemical staining of the tumour specimens for CEA. Both conventional and confocal laser scanning microscopy revealed distinct positive staining, indicating that the results obtained from the anti-CEA scanning showed specific binding of the labelled antibody in the neoplastic tissue.