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Follicular Neoplasm, Hürthle Cell (Oncocytic) Type/Suspicious for a Follicular Neoplasm, Hürthle Cell (Oncocytic) Type

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The Bethesda System for Reporting Thyroid Cytopathology

Abstract

The Hürthle cell or oncocyte is defined morphologically as a thyroid follicular cell with an abundance of finely granular cytoplasm that reflects an excessive number of mitochondria. Most Hürthle cells/oncocytes have an enlarged, round to oval nucleus, and some have a prominent nucleolus. These cells are not uncommon as a component of a benign thyroid nodule, but they raise the possibility of a Hürthle cell/oncocytic neoplasm when they are the sole cellular constituent of a fine needle aspiration. In such cases, the diagnosis “follicular neoplasm, Hürthle cell (oncocytic) type” or “suspicious for a follicular neoplasm, Hürthle cell (oncocytic) type” should be made. These terms are synonyms; a laboratory should choose the one it prefers and use it exclusively for this interpretation. This result is associated with a significant risk of malignancy (10–40%). The criteria for this diagnosis are essentially unchanged from those described in the first edition (an exclusive or virtually exclusive population of oncocytes in an architectural pattern other than flat sheets, usually scant to absent colloid, rare to absent lymphocytes, and the presence of a specially defined “small-cell” or “large-cell” dysplasia). The differential diagnosis includes benign nodules with focal Hürthle cell/oncocytic change and other neoplasms, most importantly medullary thyroid carcinoma and oncocytic variants of papillary thyroid carcinoma.

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Authors and Affiliations

  1. Department of Pathology, Massachusetts General Hospital, Massachusetts Eye and Ear, Harvard Medical School, 55 Fruit Street, Warren 219, Boston, MA, 02114, USA

    William C. Faquin

  2. Department of Pathology, University Hospitals Case Medical Center/Case Western Reserve University, Cleveland, OH, USA

    Claire W. Michael

  3. Department of Pathology, Baptist Hospital, Miami, FL, USA

    Andrew A. Renshaw

  4. Department of Pathology, National Laboratory of Health, Dudelange, Luxembourg

    Philippe Vielh

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  1. William C. Faquin
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  2. Claire W. Michael
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  3. Andrew A. Renshaw
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  4. Philippe Vielh
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Correspondence to William C. Faquin .

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Editors and Affiliations

  1. Department of Pathology, The Johns Hopkins Hospital/The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

    Syed Z. Ali

  2. Department of Pathology, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA

    Edmund S. Cibas

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Faquin, W.C., Michael, C.W., Renshaw, A.A., Vielh, P. (2018). Follicular Neoplasm, Hürthle Cell (Oncocytic) Type/Suspicious for a Follicular Neoplasm, Hürthle Cell (Oncocytic) Type. In: Ali, S., Cibas, E. (eds) The Bethesda System for Reporting Thyroid Cytopathology. Springer, Cham. https://doi.org/10.1007/978-3-319-60570-8_6

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  • DOI: https://doi.org/10.1007/978-3-319-60570-8_6

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-60569-2

  • Online ISBN: 978-3-319-60570-8

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