vmireavizВестник медицинского института «РЕАВИЗ». Реабилитация, Врач и ЗдоровьеBulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH)2226-762X2782-1579РЕАВИЗ10.20340/vmi-rvz.2026.2.MORPH.1vmireaviz-1584Research ArticleМорфология, патологияMorphology, pathologyМедуллярная карцинома щитовидной железы: современные критерии морфологической диагностикиMedullary thyroid carcinoma: current criteria for morphological diagnosishttps://orcid.org/0000-0003-2122-2297БондаренкоЕ. В.BondarenkoE. V.

Бондаренко Екатерина Владимировна - Канд. мед. наук, врач-патологоанатом, руководитель центра  биобанкирования

 ул. Дмитрия Ульянова, д. 11, г. Москва, 117292, Россия 

Ekaterina V. Bondarenko - Cand. Sci. (Med.), pathologist, head of the biobanking center

Dmitry Ulyanov st., 11, Moscow, 117292, Russia

https://orcid.org/0009-0003-5232-6440ДзампаеваК. Ш.DzampaevaK. Sh.

Дзампаева Камила Шамильевна - Врач-эндокринолог, аспирант

 ул. Дмитрия Ульянова, д. 11, г. Москва, 117292, Россия 

Kamila Sh. Dzampaeva - Endocrinologist, postgraduate student

Dmitry Ulyanov st., 11, Moscow, 117292, Russia

kamila_super9@mail.ruhttps://orcid.org/0000-0001-8580-2421АбдулхабироваФ. М.AbdulkhabirovaF. M.

Абдулхабирова Фатима Магомедовна - Канд. мед. наук, врач-эндокринолог, заведующая лабораторией цитологии и цитогенетики отдела фундаментальной патоморфологии

 ул. Дмитрия Ульянова, д. 11, г. Москва, 117292, Россия 

Fatima M. Abdulkhabirova - Cand. Sci. (Med.), endocrinologist, head of the cytology and cytogenetics laboratory of the  department of fundamental pathomorphology

Dmitry Ulyanov st., 11, Moscow, 117292, Russia

https://orcid.org/0000-0001-6388-1544ПлатоноваН. М.PlatonovaN. M.

Платонова Надежда Михайловна - Д-р мед. наук, врач-эндокринолог, заведующая отделом терапевтической эндокринологии

ул. Дмитрия Ульянова, д. 11, г. Москва, 117292, Россия 

Nadezhda M. Platonova - Dr. Sci. (Med.), Endocrinologist, Head of the Department of Therapeutic Endocrinology

Dmitry Ulyanov st., 11, Moscow, 117292, Russia

https://orcid.org/0000-0001-6891-0009УрусоваЛ. С.UrusovaL. S.

Урусова Лилия Сергеевна - Д-р мед. наук, врач-патологоанатом, заведующая отделом фундаментальной патоморфологии

 ул. Дмитрия Ульянова, д. 11, г. Москва, 117292, Россия 

Liliya S. Urusova - Dr. Sci. (Med.), Pathologist, Head of the  Department of Fundamental Pathomorphology

 Dmitry Ulyanov st., 11, Moscow, 117292, Russia 

https://orcid.org/0009-0002-7243-2091МагомедовХ. Х.MagomedovKh. Kh.

Магомедов Хамзат Хаджимурадович -Ординатор

 ул. Дмитрия Ульянова, д. 11, г. Москва, 117292, Россия 

Khamzat Kh. Magomedov - Resident

Dmitry Ulyanov st., 11, Moscow, 117292, Russia

https://orcid.org/0009-0001-8645-6150БударинаМ. М.BudarinaM. M.

Бударина Мария Михайловна - Студент

ул. Миклухо-Маклая, д. 6, г. Москва, 117198, Россия

Mariya M. Budarina - Student

Miklukho-Maklaya st., 6, Moscow, 117198, Russia

https://orcid.org/0000-0001-8284-9996АбросимовА. Ю.AbrosimovA. Yu.

Абросимов Александр Юрьевич - Д-р мед. наук, врач-патологоанатом, профессор

 ул. Дмитрия Ульянова, д. 11, г. Москва, 117292, Россия 

Aleksandr Yu. Abrosimov - Dr. Sci. (Med.), pathologist, professor

Dmitry Ulyanov st., 11, Moscow, 117292, Russia

Национальный медицинский исследовательский центр эндокринологии имени академика И.И. ДедоваРоссияNational Medical Research Centre for EndocrinologyRussian FederationРоссийский университет дружбы народов имени Патриса ЛумумбыРоссияPatrice Lumumba Peoples' Friendship University of RussiaRussian Federation202615072026162146158Copyright © Бондаренко Е.В., Дзампаева К.Ш., Абдулхабирова Ф.М., Платонова Н.М., Урусова Л.С., Магомедов Х.Х., Бударина М.М., Абросимов А.Ю., 20262026Бондаренко Е.В., Дзампаева К.Ш., Абдулхабирова Ф.М., Платонова Н.М., Урусова Л.С., Магомедов Х.Х., Бударина М.М., Абросимов А.Ю.Bondarenko E.V., Dzampaeva K.S., Abdulkhabirova F.M., Platonova N.M., Urusova L.S., Magomedov K.K., Budarina M.M., Abrosimov A.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestnik.reaviz.ru/jour/article/view/1584Актуальность

Актуальность. Медуллярная карцинома щитовидной железы представляет собой относительно редкую, но клинически значимую злокачественную опухоль, характеризующуюся выраженным морфологическим полиморфизмом и вариабельностью клинического течения. В условиях обновления классификации опухолей щитовидной железы и внедрения современных систем градации особую актуальность приобретает систематизация морфологических, иммуногистохимических и молекулярно-генетических критериев диагностики и прогностической стратификации данной опухоли.Цель: проанализировать современные представления об особенностях медуллярной карциномы щитовидной железы, критериях стратификации прогноза и выявить актуальные проблемы диагностики.Материалы и методы. Обзор выполнен в формате систематического анализа отечественной и зарубежной научной литературы, посвящённой медуллярной карциноме щитовидной железы. Поиск публикаций проводился в базах данных eLIBRARY, PubMed, Scopus и Web of Science за период с 2000 по 2026 г. с использованием ключевых слов «медуллярная карцинома щитовидной железы», «Склетки», «морфология», «иммуногистохимия», «кальцитонин», «нейроэндокринные опухоли», «RET-мутации», «grading опухолей» и их комбинаций. Отдельно были проанализированы по аналогичным запросам публикации за период 1970–2026 гг. для формирования исторической справки. Критериями включения являлись оригинальные клинические исследования, метаанализы и систематические обзоры, а также отдельные клинические случаи, содержащие данные о клинических, лабораторных, морфологических и молекулярно-генетических характеристиках медуллярной карциномы. Исключались публикации без полнотекстового доступа, дублирующие исследования. Отбор публикаций осуществлялся в два этапа: первичная оценка заголовков и аннотаций, затем полнотекстовый анализ. Анализ данных осуществлялся методом качественного синтеза.Результаты. Медуллярная карцинома щитовидной железы характеризуется разнообразием клеточного состава и структурных паттернов, что обусловливает необходимость комплексного подхода к диагностике с обязательным использованием иммуногистохимического и молекулярно-генетического исследования. Применение расширенной иммуногистохимической панели, включающей кальцитонин, РЭА, нейроэндокринные маркеры и TTF-1, является обязательным условием верификации диагноза. Дополнительную прогностическую ценность приобретает выделение high-grade, при этом особое значение имеет выявление опухолевого некроза.Заключение. Оптимальный подход к диагностике и прогнозированию медуллярной карциномы щитовидной железы должен быть интегративным и включать морфологический анализ, расширенную иммуногистохимическую панель и молекулярно-генетические методы. Реализация такого комплексного подхода позволяет повысить точность диагноза, более объективно оценивать агрессивность опухоли, а также создает платформу для более глубокого изучения медуллярной карциномы щитовидной железы и дальнейших исследований на репрезентативных выборках.

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Background. Medullary thyroid carcinoma is a relatively rare but clinically significant malignant tumor characterized by marked morphological heterogeneity and variability in clinical behavior. In the context of updated classifications of thyroid tumors and the introduction of modern tumor grading systems, the systematization of morphological, immunohistochemical, and molecular genetic criteria for diagnosis and prognostic stratification has become particularly relevant.Objective. To analyze current concepts regarding the characteristics of medullary thyroid carcinoma, criteria for prognostic stratification, and to identify current challenges in its diagnosis.Materials and methods. This review was conducted as a systematic analysis of domestic and international scientific literature on medullary thyroid carcinoma. Publications were searched in the eLIBRARY, PubMed, Scopus, and Web of Science databases for the period from 2000 to 2026 using the following keywords: “medullary thyroid carcinoma,” “C-cells,” “morphology,” “immunohistochemistry,” “calcitonin,” “neuroendocrine tumors,” “RET mutations,” “tumor grading,” and their combinations. Additionally, publications from 1970 to 2026 were analyzed using similar search strategies to provide a historical background. Inclusion criteria comprised original clinical studies, meta-analyses, systematic reviews, and selected case reports containing data on clinical, laboratory, morphological, and molecular genetic characteristics of medullary thyroid carcinoma. Publications without full-text access and duplicate studies were excluded. Study selection was performed in two stages: initial screening of titles and ABSTRACTs followed by full-text review. Data analysis was carried out using qualitative synthesis.Results. Medullary thyroid carcinoma is characterized by heterogeneity in cellular composition and architectural patterns, necessitating a comprehensive diagnostic approach with mandatory use of immunohistochemical and molecular genetic methods. The application of an extended immunohistochemical panel, including calcitonin, CEA, neuroendocrine markers, and TTF-1, is essential for diagnostic verification. Additional prognostic value is associated with the identification of high-grade features, with particular importance attributed to the presence of tumor necrosis. Conclusion. The optimal approach to the diagnosis and prognostic assessment of medullary thyroid carcinoma should be integrative, incorporating morphological evaluation, an extended immunohistochemical panel, and molecular genetic methods. Implementation of such a comprehensive strategy improves diagnostic accuracy, enables a more objective assessment of tumor aggressiveness, and provides a platform for deeper investigation of medullary thyroid carcinoma in future studies based on representative cohorts.

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The authors declare that there are no conflicts of interest present.