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A Journal on Otorhinolaryngology, Head and Neck Surgery,
Plastic Reconstructive Surgery, Otoneurosurgery

Indexed/Abstracted in: EMBASE, Scopus




Otorinolaringologia 2000 March;50(1):27-9

language: Italian

Hurthle cell tumor of the thyroid. Report of a case diagnosed with FNA as a papillary carcinoma

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.

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