Hurthle Cell Lesions- A Retrospective Review of Final Surgical Pathology

Kroeker, Teresa R.; Prisman, Eitan; Shah, Manish D.; MacMillan, Christina; Freeman, Jeremy L.

doi:10.4172/2167-7948.1000155

Cited by 2 publications

(4 citation statements)

References 28 publications

(25 reference statements)

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“…Thirdly, most studies evaluating the outcome of surgery were retrospective studies confounded by nonmatching of variables (age, gender, and tumor size) which also influence the outcome. Given the relatively small proportion of HCCs among HCN nodules and benign course identified in most miHCC, Kroeker et al [16], in agreement with previous reports of Parikh et al [46], Melck et al [27], and McHenry et al [19], have advocated thyroid lobectomy for initial management of HCNs keeping in mind two possibilities. Firstly, proceeding to total thyroidectomy may be decided immediately if extrathyroidal extension or lymphadenopathy was detected intraoperatively.…”

Section: Debates In Managementsupporting

confidence: 53%

“…Stemming from this, investigators have tried to employ demographic (age, gender, race, ethnicity), clinico-pathological criteria (tumor size, radiation history, family history, multifocality, and coexisting thyroid pathology) to better predict the risk of malignancy in HCN. Older age was found to be significantly associated with malignancy in some studies [43,44]; however, others found no significant association [16,22,45,46]. Similarly, contradictory findings were reported concerning gender association [20,27,47,48].…”

Section: Hurthle Cell Neoplasm (Hcn): the Challenge Of Benign Or Malimentioning

confidence: 97%

“…However, percentage of HCs required for the lesion to be diagnosed as HCL has been controversial. Most literature defined the lesion as HCL when oncocytes are making 75 % or more [4,15,16]. Some authors considered it a HCL when oncocytes exceed 50 % of follicular cells in fine-needle aspiration biopsy (FNAB) [17][18][19].…”

Section: Controversy Of Definition: Is It a Hurthle Cell Lesion?mentioning

confidence: 99%

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Hurthle Cell Lesion: Controversies, Challenges, and Debates

Shawky

Sakr

2015

Indian J Surg

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Hurthle cell lesion is one of the most questionable clinico-pathological entities in most of its aspects. Literature has used the terms oncocytic, oxyphilic, Hurthle, and Ashkanazy interchangeably; what does each term denote? Who first described these cells? What is the cell of origin? How much Hurthle cells should be present to define the lesion as Hurthle cell one? Is it possible to differentiate hyperplastic from neoplastic and benign from malignant Hurthle cell lesion on a non-histopathologic ground? Does it belong to follicular or to papillary neoplasms or should it be classified separately? Can we anticipate its clinical behavior or predict its outcome? How can we manage? We will try to answer these questions in light of the ongoing relevant arguments with the aim of resolving some uncertainties and suggesting how to solve others.

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Section: Debates In Managementsupporting

confidence: 53%

Section: Hurthle Cell Neoplasm (Hcn): the Challenge Of Benign Or Malimentioning

confidence: 97%

Section: Controversy Of Definition: Is It a Hurthle Cell Lesion?mentioning

confidence: 99%

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Hurthle Cell Lesion: Controversies, Challenges, and Debates

Shawky

Sakr

2015

Indian J Surg

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“…The amount of hurthle cells required for the diagnosis of HCN has been defined variably in the literature. Most authors state 75% [8,15,16] or 50% [17,18] as a defining value. In our setup, pathologists use variable cutoff values.…”

Section: Discussionmentioning

confidence: 99%

Rate and Clinical Predictors of Malignancy in Thyroid Nodules with Indeterminate Cytology

Tefera

2021

CSRC

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Background: Fine needle aspiration cytology (FNAC) cannot differentiate between benign and malignant conditions in cytologically indeterminate thyroid lesions. Therefore, a minimum of diagnostic lobectomy is required for definitive diagnosis. The objective of this study is to identify the rate of malignancy and clinical features that may possibly predict malignancy in patients with these lesions, in Ethiopian hospitals. Methods: This was a retrospective review of the medical records of patients who underwent surgery for cytologically indeterminate thyroid lesions in three referral hospitals between September 2015 and September 2020. Results: Of 85 patients with indeterminate cytology findings, 56 (63.5%) were follicular, and 29 (34.1%) were reported to be hurthle cell neoplasms. Follicular lesions of undetermined significance (FLUS) and suspicious for follicular neoplasm were each reported in single cases (1.7%). Malignant disease was diagnosed in 19 (22.4%) of patients. A follicular variant of papillary cancer was detected in 7 (11.5%) patients. Hard nodule consistency was reported in 9 of 11 malignant lesions and 5 of 66 benign lesions. In multivariate binary logistic regression, hard nodule consistency was found to be associated with malignancy (P = 0.012, AOR = 7.28 (1.5, 34.54) 95% CI ). The ill-defined surface of a nodule was found to be associated with malignancy though the association was not statistically significant (P = 0.088, AOR = 0.162 (0.020, 1.313) 95% CI. Ultrasound evaluation of thyroid nodule was performed only in 41 (47.7%) of patients. Conclusion: The rate of malignancy in thyroid nodules with indeterminate cytology was 22.4%. The risk of malignancy was higher in patients with hard thyroid nodule consistency and ill-defined surface. Despite the established benefits of ultrasound for the evaluation of thyroid nodules, the current practice of its use in our setup is suboptimal. Keywords: Follicular; hurthle cell; indeterminate cytology; predictors of malignancy

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Hurthle Cell Lesions- A Retrospective Review of Final Surgical Pathology

Cited by 2 publications

References 28 publications

Hurthle Cell Lesion: Controversies, Challenges, and Debates

Hurthle Cell Lesion: Controversies, Challenges, and Debates

Rate and Clinical Predictors of Malignancy in Thyroid Nodules with Indeterminate Cytology

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