Hürthle Cell Neoplasms of the Thyroid

Maizlin, Zeev V.; Wiseman, Sam M.; Vora, Parag; Kirby, John M.; Mason, Andrew C.; Filipenko, Douglas; Brown, Jacqueline A.

doi:10.7863/jum.2008.27.5.751

Cited by 39 publications

(7 citation statements)

References 38 publications

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“…The majority of studies concern cases of cytologically suspected HN (currently SHCT), but they often include a period before the introduction of Bethesda classification, and thus before establishing category III. In some cases, the reports do not consider FNA outcomes, but they are focused on ultrasonographic differentiation between histopathologically confirmed HTC and HTA [17][18][19][20][21][22][23]. Maizlin et al (2008) showed that such nodules displayed a wide spectrum of sonographic appearances and that ultrasonography did not help in distinguishing benign and malignant HN [18].…”

Section: Discussionmentioning

confidence: 99%

Usability of EU-TIRADS in the Diagnostics of Hürthle Cell Thyroid Nodules with Equivocal Cytology

Słowińska-Klencka

Wysocka-Konieczna

Klencki

et al. 2020

JCM

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The aim of this study was to compare the diagnostic effectiveness of EU-TIRADS in two groups of nodules with equivocal cytology (categories III-V of Bethesda system), with and without Hürthle cells (HC and non-HC). The study included 162 HC and 378 non-HC nodules with determined histopathological diagnosis (17.9% and 15.6% cancers). In both groups calculated and expected risk of malignancy (RoM) for high, intermediate and benign risk categories of EU-TIRADS were concordant. RoM for low risk category was higher than expected in both groups, but especially in HC (HC: 13.9%, non-HC: 7.0%, expected: 2–4%). The majority of cancers in HC of that category were follicular thyroid carcinomas (FTC) and Hürthle cell thyroid carcinoma (HTC) (60.0% vs. non-HC: 16.7%). The diagnostic efficacy of EU-TIRADS was lower in HC (the area under the receiver operating characteristics curve (AUC): 0.621, sensitivity (SEN): 44.8%, specificity (SPC): 78.9% for high risk threshold) than in non-HC (AUC: 0.711, SEN: 61.0%, SPC: 77.7%). AUC was the highest for category V (AUC > 0.8, both groups) and the lowest for category IV (inefficient, both group). If intermediate risk category was interpreted as an indication for surgery, 25% of cancers from category III and 21.4% from category IV would not be treated in the HC group (0.0% and 7.4% from non-HC group, respectively). EU-TIRADS does not aid making clinical decisions in patients with cytologically equivocal HC nodules, particularly those classified into category IV of Bethesda System for Reporting Thyroid Cytopathology (BSRTC).

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Section: Discussionmentioning

confidence: 99%

Usability of EU-TIRADS in the Diagnostics of Hürthle Cell Thyroid Nodules with Equivocal Cytology

Słowińska-Klencka

Wysocka-Konieczna

Klencki

et al. 2020

JCM

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“…Pisanu et al [41] concluded that US findings were not useful in differentiating HCA from HCC based on a study of 41 patients. A study that examined the US appearance of 15 histologically proven cases of HCN [42] concluded that pathological criteria which differentiate HCA from HCC are beyond the resolution of US, thus precluding the usefulness of US in their characterization. …”

Section: Discussionmentioning

confidence: 99%

A Unique Case of Bilateral Hürthle Cell Adenoma in an Adolescent

Kochummen

Tong²,

Umpaichitra³

et al. 2016

Horm Res Paediatr

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Background: Hürthle cell (HC) neoplasms are rare among pediatric thyroid cancers. HC adenomas (HCA) are typically benign and localized unilaterally without recurrence, and they are thus treated by hemithyroidectomy. HC carcinomas (HCC) can be bilateral and are more aggressive, necessitating total thyroidectomy. Diagnosis relies upon surgical histopathology demonstrating invasion for classification as HCC or lack of invasion in HCA, since fine needle aspiration fails to differentiate between the two. Methods: We report a case of a 14-year-old adolescent female with bilateral HCA. She had an initial left hemithyroidectomy for a large nodule measuring 2 × 1.5 × 1.2 cm³ in the left lobe, while smaller subcentimeter nodules remained under surveillance in the right. One year later, a nodule in the right lobe doubled in size, necessitating a right hemithyroidectomy which also revealed HCA. Conclusion: To our knowledge, this is the first reported case of bilateral HCA in pediatrics. It highlights the importance of close surveillance of persistent small nodules, even in patients with previously documented benign lesions such as HCA, which are typically thought to be unilateral and localized. Both HCA and HCC remain unpredictable in behavior, and treatment of HCA should be individualized.

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“…In the absence of identifiable invasive or metastatic disease on imaging studies, it is usually impossible to distinguish between a benign Hürthle cell process or neoplasm and HCC; for this reason, histologic evaluation based on a surgical specimen is generally necessary. Ultrasound alone is unable to distinguish HCC from other histologic variants, as it can clinically demonstrate a spectrum of sonographic findings from hypoechogenicity to hyperechogenicity14 (Figure 4). …”

Section: Diagnosismentioning

confidence: 99%

Hürthle cell carcinoma: current perspectives

Ahmadi¹,

Stang²,

Jiang³

et al. 2016

OTT

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Hürthle cell carcinoma (HCC) can present either as a minimally invasive or as a widely invasive tumor. HCC generally has a more aggressive clinical behavior compared with the other differentiated thyroid cancers, and it is associated with a higher rate of distant metastases. Minimally invasive HCC demonstrates much less aggressive behavior; lesions <4 cm can be treated with thyroid lobectomy alone, and without radioactive iodine (RAI). HCC has been observed to be less iodine-avid compared with other differentiated thyroid cancers; however, recent data have demonstrated improved survival with RAI use in patients with HCC >2 cm and those with nodal and distant metastases. Patients with localized iodine-resistant disease who are not candidates for a wait-and-watch approach can be treated with localized therapies. Systemic therapy is reserved for patients with progressive, widely metastatic HCC.

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Hürthle Cell Neoplasms of the Thyroid

Cited by 39 publications

References 38 publications

Usability of EU-TIRADS in the Diagnostics of Hürthle Cell Thyroid Nodules with Equivocal Cytology

Usability of EU-TIRADS in the Diagnostics of Hürthle Cell Thyroid Nodules with Equivocal Cytology

A Unique Case of Bilateral Hürthle Cell Adenoma in an Adolescent

Hürthle cell carcinoma: current perspectives

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Hürthle Cell Neoplasms of the Thyroid

Cited by 39 publications

References 38 publications

Usability of EU-TIRADS in the Diagnostics of Hürthle Cell Thyroid Nodules with Equivocal Cytology

Usability of EU-TIRADS in the Diagnostics of Hürthle Cell Thyroid Nodules with Equivocal Cytology

A Unique Case of Bilateral Hürthle Cell Adenoma in an Adolescent

H&uuml;rthle cell carcinoma: current perspectives

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Hürthle cell carcinoma: current perspectives