[455] Cytohistologic Correlations of 124 Hürthle Cell Lesions

Grace CH Yang, Andrew M Schreiner, Wei Sun. Weill Medical College of Cornell University, New York; New York University School of Medicine, New York

Background: Hürthle cell lesions are common in thyroid FNA. This study is to find out the frequency of various cytologic features in Hürthle cell lesions and correlated with histology.
Design: We have performed on-site assessments for > 10,000 ultrasound-guided thyroid FNAs since 1995. 124 out of 239 (51.8%) cases of Hürthle cell-rich, lymphocyte absent aspirates had histology for examination and are the basis of this study.
Results:

Clinical Data

Histology	Cases	Age	M:F	Cm
HCa, widely invasive	7	33-91(70)	4:3	4-12.5(6.3)
HCa, angioinvasive	6	31-89(53)	1:5	1.6-5(3)
HCa, capsular invasion only	13	25-77(54)	5:8	1.1-5.2(2.7)
Adenoma	64	23-87(53)	18:46	0.7-7(2.8)
Adenomatoid nodule*	22	25-68(49)	5:17	0.7-4.8(2)
Thyroiditis	12	27-70(49)	0:12	1-4.5(2)

HCa: Hürthle cell carcinoma; *Hürthle cell nodule, unencapulated and no coexisting thyroiditis

Cytologic and Histologic Features

Pathology	Macrofollicles on Histology	Microfollicles	Isolated-cell pattern	Small cell dysplasia	Large cell dysplasia	Transgressing blood vessels	Thin colloid
HCa, widely invasive	0(0%)	3(43%)	3(43%)	4(57%)	3(43%)	2(29%)	0(0%)
HCa, angioinvasive	3(50%)	3(50%)	1(17%)	1(17%)	1(17%)	0(0%)	1(17%)
HCa, capsular invasion only	4(31%)	7(54%)	4(31%)	6(46%)	4(31%)	5(38%)	1(8%)
Adenoma	21(33%)	32(50%)	9(14%)	22(34%)	10(16%)	15(23%)	10(16%)
Adenomatoid nodule	12(55%)	10(45%)	3(14%)	5(23%)	0(0%)	2(9%)	7(32%)
Thyroiditis	4(33%)	10(83%)	0(0%)	0(0%)	2(17%)	0(0%)	4(33%)

Figure 1 Angioinvasive HCa with abundant colloid in cytology and histology.

Figure 2 Adenomatoid Hürthle cell nodule with small cell dysplasia in cytology and histology(arrow).


Conclusions: Abundant colloid may rarely occur in HCa. Small cell dysplasia, large cell dysplasia, isolated-cell pattern, microfollicles and transgressing blood vessels may occur in adenomatoid Hürthle cell nodules. Histologic study shows that macrofollicles are frequent in Hürthle cell tumors and the lining cells along the macrofollicles have scanty cytoplasm.
Category: Cytopathology

Wednesday, March 21, 2012 1:00 PM

Poster Session VI # 66, Wednesday Afternoon