Don’t be fooled by a thyroid biopsy report with Hürthle Cells. This is not usually cancer and they are found in all benign thyroid diseases.
1.The cytology below is of Hurthle cell metaplasia in a Hashimoto’s thyroiditis.
2.This is not Hurthle cell neoplasm or cancer.
3. HC are seen in all thyroid diseases.
4. There is lymphoid tangles of lymphocytes and plasma cells in the lower left and a large cluster of Hurthle cell to the right.This is Hashimoto’s thyroiditis not cancer.
5.The Significance of Hürthle Cells in Thyroid Disease.
6. Ask for a second cytology opinion if they want you to have surgery based on the presence of Hurthle cells.
7.The description of HCs on FNAB reports may cause significant concern to the clinician.
8.Not all oxyphilic cells are true HCs and not every aspirate containing HCs is or should be considered equivalent to an HC neoplasm (HCN).
9.There are many benign thyroid lesions associated with HCs or HC change.
10.For clinicians, it may be difficult to discern the significance of these findings and to determine an appropriate course of action.
11.A skilled and experienced cytopathologist is invaluable in discriminating the subtle features that distinguish these lesions from those warranting a more aggressive surgical approach.
12.Not all oncocytic cells in the thyroid are true HCs.
13.HCs may be found in a wide variety of conditions affecting the thyroid gland; they are not specific to any particular pathology.
14. They are commonly found in older individuals, those who have undergone thyroid irradiation, and patients with long-standing nodular goiters, Graves’ disease, and CLT.
15.The classic definition of Hashimoto’s disease calls for the triad of lymphocytes, plasma cells, and HCs.
16.Hashimoto’s thyroiditis is, in most cases, a diffuse process, but in some instances discrete nodules may be dominant.
17.HCs are also seen in neoplastic diseases of the thyroid, both benign and malignant, including HCA, HCC, variants of PTC, and the oncocytic variant of MTC, among others.
18. MicroRNA (miRNA) analysis is yet another emerging tool in the quest to differentiate benign from malignant lesions.
19.Not all lesions with HCs on FNAB require surgical intervention.
Call me for a second opinion on the need for surgery with a needle biopsy with Hurthle cells.