Wu Howard Her-Juing, Clouse Jolene, Ren Rulong
Department of Pathology, Ball Memorial Hospital and PA Labs, Muncie, Indiana 47303, USA.
Diagn Cytopathol. 2008 Mar;36(3):149-54. doi: 10.1002/dc.20750.
Specific criteria for the diagnosis of fine-needle aspiration (FNA) of Hürthle Cell Carcinoma (HCC) have rarely been discussed in the literature. A retrospective review of 35 FNA cases with the diagnosis of Hürthle cell lesion or Hürthle cell neoplasm was performed. In each case, there was a subsequent surgical excision. The FNA specimens were divided according to histologic diagnoses as HCC (12 cases), Hürthle cell adenoma (HCA) (14 cases), and benign nonneoplastic Hürthle cell lesions (BNHCL) (9 cases). Each case was examined using a semiquantitative scoring system for the following 11 features: presence or absence of colloid, lymphocytes, and transgressed blood vessels (each scored 0 or 1); the percentage of nuclear enlargement, small cell dysplasia, large cell dysplasia, nuclear crowding, and cellular dyshesion (each scored 0-3); and age, gender, and size of lesion. When diagnosed by FNA as either Hürthle cell neoplasm or Hürthle cell lesion, males were much more likely to have malignant tumors than females. Statistically significant cytologic features that favored malignant (HCC) over benign lesions (HCA and BNHCL) included small cell dysplasia, large cell dysplasia, nuclear crowding, and cellular dyshesion. The presence of colloid and lymphocytes favored a benign lesion. Nuclear enlargement and large tumor size are significantly more common in neoplasms than BNHCL.
文献中很少讨论诊断许特莱细胞癌（HCC）细针穿刺（FNA）的具体标准。对35例诊断为许特莱细胞病变或许特莱细胞瘤的FNA病例进行了回顾性研究。每例病例随后均进行了手术切除。FNA标本根据组织学诊断分为HCC（12例）、许特莱细胞腺瘤（HCA）（14例）和良性非肿瘤性许特莱细胞病变（BNHCL）（9例）。对每例病例使用半定量评分系统检查以下11项特征：有无胶体、淋巴细胞和侵犯血管（每项评分为0或1）；核增大、小细胞异型性、大细胞异型性、核拥挤和细胞黏附丧失的百分比（每项评分为0 - 3）；以及年龄、性别和病变大小。当FNA诊断为许特莱细胞瘤或许特莱细胞病变时，男性比女性更有可能患有恶性肿瘤。与良性病变（HCA和BNHCL）相比，支持恶性（HCC）的具有统计学意义的细胞学特征包括小细胞异型性、大细胞异型性、核拥挤和细胞黏附丧失。胶体和淋巴细胞的存在提示为良性病变。核增大和肿瘤体积大在肿瘤中比BNHCL更常见。
