Kure Shoko, Ohashi Ryuji
Integrated Diagnostic Pathology, Nippon Medical School, 1-1-5 Sendagi, Bunkyoku, Tokyo 113-8602, Japan.
Cancers (Basel). 2020 Dec 23;13(1):26. doi: 10.3390/cancers13010026.
Hürthle cell carcinoma (HCC) represents 3-4% of thyroid carcinoma cases. It is considered to be more aggressive than non-oncocytic thyroid carcinomas. However, due to its rarity, the pathological characteristics and biological behavior of HCC remain to be elucidated. The Hürthle cell is characterized cytologically as a large cell with abundant eosinophilic, granular cytoplasm, and a large hyperchromatic nucleus with a prominent nucleolus. Cytoplasmic granularity is due to the presence of numerous mitochondria. These mitochondria display packed stacking cristae and are arranged in the center. HCC is more often observed in females in their 50-60s. Preoperative diagnosis is challenging, but indicators of malignancy are male, older age, tumor size > 4 cm, a solid nodule with an irregular border, or the presence of psammoma calcifications according to ultrasound. Thyroid lobectomy alone is sufficient treatment for small, unifocal, intrathyroidal carcinomas, or clinically detectable cervical nodal metastases, but total thyroidectomy is recommended for tumors larger than 4 cm. The effectiveness of radioactive iodine is still debated. Molecular changes involve cellular signaling pathways and mitochondria-related DNA. Current knowledge of Hürthle cell carcinoma, including clinical, pathological, and molecular features, with the aim of improving clinical management, is reviewed.
许特莱细胞癌（HCC）占甲状腺癌病例的3%-4%。它被认为比非嗜酸性甲状腺癌更具侵袭性。然而，由于其罕见性，HCC的病理特征和生物学行为仍有待阐明。许特莱细胞在细胞学上的特征是细胞大，胞质丰富、嗜酸性、呈颗粒状，核大、深染，核仁突出。胞质颗粒状是由于存在大量线粒体。这些线粒体显示出紧密堆积的嵴并排列在中央。HCC在50-60多岁的女性中更常见。术前诊断具有挑战性，但根据超声检查，恶性肿瘤的指标包括男性、年龄较大、肿瘤大小>4cm、边界不规则的实性结节或存在砂粒体钙化。对于小的、单灶性、甲状腺内癌或临床上可检测到的颈部淋巴结转移，单纯甲状腺叶切除术是足够的治疗方法，但对于大于4cm的肿瘤，建议行全甲状腺切除术。放射性碘的有效性仍存在争议。分子变化涉及细胞信号通路和线粒体相关DNA。本文综述了目前关于许特莱细胞癌的知识，包括临床、病理和分子特征，旨在改善临床管理。
