Hürthle Cell Neoplasms in Hematoxylin-Eosin-Stained Samples
Hürthle cell neoplasms have been cytologically placed in a category distinct from follicular neoplasms in our past experience. Cytological features of hematoxylin-eosin-stained specimens diagnosed as “suspected Hürthle cell neoplasms” include that the aspirate is generally high cellular, is comprised exclusively of Hürthle cells, has well-defined cell borders with enlarged nuclei, has abundant granular cytoplasm, and has round, oval to polygonal nuclei sometimes with prominent macronucleoli. The background is usually clean or bloody with or without histiocytes. Hürthle cell metaplasia of follicular cells is seen in several conditions affecting the thyroid, displaying a range of cytological features that mimic those encountered in Hürthle cell neoplasms, constituting important diagnostic pitfalls. An admixture of regular follicular cells, oncocytes with highly pleomorphic in size, transition forms, degenerative changes with histiocytes, lymphocytes or colloid in the background, absent macronucleus could serve as the clues to the diagnosis of nonneoplastic Hürthle cell nodules.
KeywordsHürthle cell Monomorphic Hematoxylin-eosin-stained Nonneoplastic Oncocytic variant
- 1.Kini SR et al. Thyroid Cytopathology 2nd: An Atlas and Text; 2015. p. 119–150.Google Scholar
- 8.Luis LMD, Alice CCMD, Ana OHMD, et al. Prognostic factors in patients with Hürthle cell neoplasms of the thyroid. Cancer. 2010;97:1186–94.Google Scholar
- 9.RA DL. World Health Organization classification of tumours. In: Lloyd RV, Heitz PU, Eng C, editors. Pathology and genetics of tumours of endocrine organs. Lyon: IARC Press; 2017. p. 96–9.Google Scholar
- 10.Cibas ES, Ali SZ, editors. The Bethesda system for reporting thyroid cytopathology. 2nd ed. New York, NY: Thyroid Official Journal of the American Thyroid Association, Springer; 2017. p. 81–100.Google Scholar
- 12.Rosai J, DeLellis RA, Carcangiu ML, Frable WJ, Tallini G. Tumors of the thyroid gland and parathyroid gland. Atlas of Tumor Pathology, Series 4. Washington, DC: Armed Forces Institute of Pathology; 2014.Google Scholar