When is A Thyroid nodule with Hurthle cells not a neoplasm but part of a chronic thyroidits?

When is A Thyroid nodule with Hurthle cells not a neoplasm but part of a chronic thyroidits?

When is A Thyroid nodule with Hurthle cells not a neoplasm but part of a chronic thyroidits?

When is A Thyroid nodule with Hurthle cells not a neoplasm but part of a chronic thyroidits?

Answer: When there are lymphocytes seen in the Hurthle cell nodule.

 jcytol-31-236-g001
(a) Hürthle cells showed moderate nuclear pleomorphism, and few cells showed prominent nucleoli, (b) occasional lymphocyte in Hürthle cell sheets (arrow), (Leishman stain ×400)

A focal nodular Hürthle cell hyperplasia in Hashimoto’s thyroiditis: A diagnostic dilemma on fine needle aspiration.

J Cytol. 2014 Oct-Dec;31(4):236-8.
1. Hürthle cells are seen in a variety of nonneoplastic and neoplastic thyroid gland lesions.
2. Number and morphology of Hürthle cell vary in thyroid aspirate.
3. Occasionally, thyroid aspirate in focal nodular Hürthle cell hyperplasia in Hashimoto’s thyroiditis exclusively comprise of Hürthle cells and mimics Hürthle cell neoplasm.
4. Fine needle aspiration (FNA) diagnosis in such cases is challenging.
5. A 60-year-old female presented with goiter and clinical features of hyperthyroidism.
6. FNA smears showed Hürthle cells arranged in flat sheets and lying singly with occasional lymphocytes in Hürthle cell sheets.
7. Repeat aspiration from other site showed lymphocytes, infiltrating the thyroid follicular cells.
8. Search of lymphocytes in Hürthle cell sheets in cytology smears, multiple aspirates, associated clinical findings and ancillary techniques reduce the diagnostic pitfall and avoid unnecessary surgery.

KEYWORDS:

Fine needle aspiration cytology; Hürthle cells; nodule; thyroid

Add Your Comment

Contact Info
1328 16th Street, Santa Monica, CA 90404
Monday – Friday
9:00 AM to 5:00 PM
(310) 393-8860