INTRODUCTION: Fine needle aspiration (FNA), although it is very reliable diagnostic tool for malignant thyroid nodules, cannot distinguish benign lesions from malignant lesions in the cases of Hurthle cell neoplasm. Preoperative estimation of the risk of malignancies is very important for optimal treatment of patients
PURPOSE: We evaluated predictors of malignancy in patients with cytologically suspicious for Hurthle cell neoplasm in thyroid nodules.
MATERIALS AND METHODS: Between January 2007 and December 2007, 5165 US-guided fine-needle aspirations (US-FNA) were performed at our institution. We searched cases with cytologically suspicious for Hurthle cell neoplasm. Among them, nodules that were confirmed surgically or followed-up for at least 2 years were compared with respect to age, gender, tumor size, US diagnosis, and US findings (margin, shape, echogenicity, presence of calcification and cystic change) to predict the malignancy.
RESULTS: The incidence of cytologically suspicious for Hurthle cell neoplasm was 1.4% (71 of 5165 US-FNAs). Of 37 nodules undergone sufficient follow-up or surgery, malignancies were found in 6 (16%). These histologies showed oncocytic variant of papillary carcinomas in 2, classic type of papillary carcinoma in 1, Hurthle cell carcinoma in 1, follicular carcinoma in 1, and unclassified carcinoma in 1. Suspicious US diagnosis had a higher rate in malignant nodules than in benign nodules (P=0.013). There were no significant differences in age, gender, nodule size, margin, and US findings between two benign and malignant nodules.
CONCLUSION: The incidence of suspicious for Hurthle cell neoplasm at cytology is rare. However, US diagnosis may predict its malignant potential.
CLINICAL RELEVANCE: Preoperative estimation of US findings of cytologically suspicious Hurthle cell carcinoma can affect for surgeons to decide the extent of operation and to reduce the rate of reoperation due to malignancies.
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SS 07 TH-03.pdf
