Ghofrani Mohiedean, Sosa Julie Ann, Ocal Idris Tolgay, Angeletti Cesar
Cytology Division, Department of Pathology, Yale University School of Medicine, New Haven, Connecticut 06520-8023, USA.
Acta Cytol. 2006 Sep-Oct;50(5):560-2. doi: 10.1159/000326016.
Poorly differentiated oxyphilic (Hürthle cell) carcinomas are a more recently described variant of poorly differentiated thyroid carcinoma and are characterized by a prominent Hürthle cell component in a solid or trabecular arrangement. Clinically, poorly differentiated oxyphilic carcinomas behave more aggressively as compared to classic Hürthle cell carcinomas, which have a predominantly follicular pattern. Although the histology of these rare thyroid tumors has been reported in the literature, the cytologic features on fine needle aspiration biopsy have not been described before.
A 73-year-old man with a long history of radioactive iodine and levothyroxine therapy for multinodular goiter presented with a painful, rapidly expanding, 6-cm, left thyroid mass with aggressive radiologic features. Fine needle aspiration biopsy of the mass yielded extremely cellular smears with a dual population of medium-sized follicular cells and numerous Hürthle cells. Subsequent thyroidectomy confirmed the malignant nature of this Hürthle cell-rich tumor, warranting a diagnosis of poorly differentiated oxyphilic (Hürthle cell) thyroid carcinoma.
Poorly differentiated oxyphilic thyroid carcinoma is an aggressive variant of Hürthle cell carcinomas and must enter the differential diagnosis when fine needle aspiration biopsy of a radiologically aggressive thyroid mass yields extremely hypercellular smears with a prominent Hürthle cell component.
低分化嗜酸性（许特莱细胞）癌是一种最近才被描述的低分化甲状腺癌变体，其特征是在实性或小梁状排列中存在显著的许特莱细胞成分。临床上，与主要为滤泡状模式的经典许特莱细胞癌相比，低分化嗜酸性癌的行为更具侵袭性。尽管这些罕见甲状腺肿瘤的组织学在文献中已有报道，但细针穿刺活检的细胞学特征此前尚未被描述。
一名73岁男性，有放射性碘和左甲状腺素治疗多结节性甲状腺肿的长期病史，出现一个疼痛、迅速增大的6厘米左侧甲状腺肿块，具有侵袭性放射学特征。对该肿块进行细针穿刺活检，涂片细胞极为丰富，有中等大小滤泡细胞和大量许特莱细胞的双细胞群。随后的甲状腺切除术证实了这个富含许特莱细胞肿瘤的恶性性质，确诊为低分化嗜酸性（许特莱细胞）甲状腺癌。
低分化嗜酸性甲状腺癌是许特莱细胞癌的一种侵袭性变体，当对具有侵袭性放射学特征的甲状腺肿块进行细针穿刺活检，涂片细胞极度增多且有显著的许特莱细胞成分时，必须将其纳入鉴别诊断。
