Tuzun Dilek, Ersoy Reyhan, Yazgan Aylin Kilic, Kiyak Gulten, Yalcin Samet, Cakir Bekir
Department of Endocrinology and Metabolism, Ankara Atatürk Education and Research Hospital, Ankara, Turkey.
Department of Endocrinology and Metabolism, Yildirim Beyazit University, Ankara, Turkey.
Ann Diagn Pathol. 2015 Jun;19(3):175-9. doi: 10.1016/j.anndiagpath.2015.03.002. Epub 2015 Mar 6.
This study was designed to evaluate the ultrasonographic and histopathologic features of nodules composed predominantly of Hurthle cells detected during cytological examination. Fifty-seven patients with thyroid nodules composed predominantly of Hurthle cells on fine needle aspiration cytology were retrospectively analyzed. Patients were evaluated by thyroid ultrasonography (US), and biopsy samples taken by US-guided fine needle aspiration cytology were assessed histopathologically. There were 57 patients and 57 nodules with Hurthle cells in cytological examination; 49 (86%) were classified as Bethesda 1, and 8 (14%) were classified as Bethesda 3. Histopathologically, 45 (78.9%) nodules were benign and 12 (21.1%) were malignant. Nuclear groove, transgressing blood vessel, and absence of colloid were observed with a higher frequency in malignant nodules compared to benign nodules (P < .05). There were no specific morphological features (nodule echogenity, presence of microcalsification, presence of cystic areas, absence of halo, margin irregularity, and increased blood flow) predicting malignancy in the US evaluation of nodules including Hurthle cells. Nuclear groove, transgressing blood vessel, and absence of colloid on cytomorphological evaluation are indicative of malignancy in nodules containing Hurthle cells.
本研究旨在评估在细胞学检查中检测到的以许特耳细胞为主的结节的超声和组织病理学特征。对57例细针穿刺细胞学检查显示以许特耳细胞为主的甲状腺结节患者进行回顾性分析。对患者进行甲状腺超声（US）检查，并对超声引导下细针穿刺细胞学获取的活检样本进行组织病理学评估。细胞学检查中有57例患者和57个含许特耳细胞的结节；49个（86%）被分类为贝塞斯达1类，8个（14%）被分类为贝塞斯达3类。组织病理学上，45个（78.9%）结节为良性，12个（21.1%）为恶性。与良性结节相比，恶性结节中核沟、血管侵犯和无胶质的观察频率更高（P <.05）。在对包括许特耳细胞结节的超声评估中，没有特定的形态学特征（结节回声、微钙化的存在、囊性区域的存在、晕圈的缺失、边缘不规则和血流增加）可预测恶性。在细胞形态学评估中，核沟、血管侵犯和无胶质表明含许特耳细胞的结节为恶性。
