Yang Y J, Khurana K K
Department of Pathology, SUNY Upstate Medical University Hospital, 750 East Adams St., Syracuse, NY 13210, USA. .
Arch Pathol Lab Med. 2001 Aug;125(8):1031-5. doi: 10.5858/2001-125-1031-DUOILA.
Recent abstracts have emphasized the importance of recognizing intracytoplasmic lumen and transgressing vessels as useful criteria enabling distinction between Hürthle cells encountered in neoplastic and nonneoplastic thyroid aspirates. The purpose of this retrospective study was to evaluate if application of these criteria improves specificity and sensitivity of cytologic diagnosis of true Hürthle cell neoplasms.
We retrospectively reviewed 30 fine-needle aspirates of thyroid with cytologic diagnosis of Hürthle cell neoplasms (13 cases) and nonneoplastic thyroid with prominent Hürthle cells (17 cases). All cases were evaluated for the presence of intracytoplasmic lumen and transgressing vessels and were reclassified as neoplastic or nonneoplastic based on the presence or absence of 1 or both of these criteria. Surgical follow-up was available in all cases.
Surgical follow-up in 13 cases of Hürthle cell neoplasms revealed Hürthle cell carcinoma (3 cases), Hürthle cell adenoma (6 cases), and Hashimoto's thyroiditis (4 cases). Seventeen cases with nonneoplastic diagnosis revealed Hürthle cell carcinoma (1 case), Hashimoto's thyroiditis (12 cases), and nodular goiter (4 cases). After application of the previously mentioned cytologic criteria, the cytologic diagnoses were reclassified as Hürthle cell neoplasms (13 cases) and nonneoplastic thyroid (17 cases). The true sensitivity of the test before and after the application of the criteria was 90% and 100%, respectively. The true specificity before and after the application of the cytologic criteria was 65% and 85%, respectively.
Intracytoplasmic lumen and transgressing vessels are helpful features in distinguishing neoplastic and nonneoplastic Hürthle cell thyroid lesions. Use of these criteria may improve the specificity and sensitivity of the cytologic diagnosis.
近期的摘要强调了识别胞质内管腔和穿破血管作为有用标准的重要性，这些标准有助于区分肿瘤性和非肿瘤性甲状腺细针穿刺抽吸物中出现的许特莱细胞。这项回顾性研究的目的是评估应用这些标准是否能提高真正的许特莱细胞瘤细胞学诊断的特异性和敏感性。
我们回顾性分析了30例甲状腺细针穿刺抽吸物，其中细胞学诊断为许特莱细胞瘤（13例）以及有显著许特莱细胞的非肿瘤性甲状腺（17例）。评估所有病例中是否存在胞质内管腔和穿破血管，并根据是否存在这一项或两项标准将病例重新分类为肿瘤性或非肿瘤性。所有病例均有手术随访结果。
13例许特莱细胞瘤的手术随访结果显示为许特莱细胞癌（3例）、许特莱细胞腺瘤（6例）和桥本甲状腺炎（4例）。17例非肿瘤性诊断的病例显示为许特莱细胞癌（1例）、桥本甲状腺炎（12例）和结节性甲状腺肿（4例）。应用上述细胞学标准后，细胞学诊断重新分类为许特莱细胞瘤（13例）和非肿瘤性甲状腺（17例）。应用标准前后该检测的真敏感性分别为90%和100%。应用细胞学标准前后的真特异性分别为65%和85%。
胞质内管腔和穿破血管有助于区分肿瘤性和非肿瘤性许特莱细胞甲状腺病变。使用这些标准可能会提高细胞学诊断的特异性和敏感性。
