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Indexed/Abstracted in: EMBASE, Scopus
Online ISSN 1827-188X
Ballotta M. R., Borghi L., Bianchini E., Ravasi A. *
Ospedale Civile - Rovigo Unità Operativa di Anatomia Patologica
*Unità Operativa Otorinolaringoiatrica
A case of microfollicular Hurthle cell tumor with pseudopapillary aspects, which cytologic appearance was consistent with a papillary neoplasm, is described. Before the widespread use of fine needle aspiration (FNA) of thyroid nodules, only 11% of thyroid nodules removed at operation contained carcinomas. Several non invasive techiques have been used to increased the percentage of carcinomas in thyroid nodules found in patients who undergo surgery. Radionuclide scans and ultrasonography eliminate the need for an operation in only 10-20% of patients who seek care because of thyroid nodules that could indicate a neoplasm. Thus, FNA cytology holds an important place in the workup of palpable thyroid lesions. Because architectural features of capsular invasion and angioinvasion are used to determine malignant potential, insufficient cytologic criteria are available to definitively separate adenoma from carcinoma even if some aspects could favor malignant behavior. In the present case the FNA smears were consistent with a papillary neoplasm because of they contained small clusters and pseudopapillary aggregates of cells with nuclear grooves and intranuclear pseudoinclusions. Histologic examination of the nodule after surgery showed a microfollicular,pseudopapillary Hurtle cell adenoma with nuclear groves and pseudoinclusions. No capsular invasion and angioinvasion were demonstrated. The conclusions is drawn that FNA seems to be the most accurate and rapid technique in recognizing the tumors as lesions requiring surgical excision.