Differential Diagnosis of Hürthle Cell Neoplasms on Fine Needle Aspirates

1997 ◽  
Vol 41 (1) ◽  
pp. 197-208 ◽  
Author(s):  
Stefan E. Pambuccian ◽  
Robert L. Becker, Jr. ◽  
Syed Z. Ali ◽  
Kay Savik ◽  
Dorothy L. Rosenthal
Keyword(s):  
Differential Diagnosis ◽  
Fine Needle ◽  
Fine Needle Aspirates ◽  
Hürthle Cell

Cytotechnologist Performance for Screening Hürthle Cell Atypia in Indeterminate Thyroid Fine-Needle Aspirates

2015 ◽  
Vol 59 (5) ◽  
pp. 377-383 ◽  
Author(s):  
Christopher J. VandenBussche ◽  
Christina Adams ◽  
Syed Z. Ali ◽  
Matthew T. Olson
Keyword(s):  
Diagnostic Errors ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Fine Needle Aspirates ◽  
Hürthle Cell ◽  
Thyroid Fine Needle Aspiration ◽  
Hurthle Cells ◽  
Hürthle Cells ◽  
Almost All ◽  
Cell Atypia

Objectives: We have previously shown that specimens diagnosed as containing Hürthle cells have a 12% chance of being malignant if they are classified as atypia of undetermined significance (AUS-HC). The identification of Hürthle cells by cytotechnologists (CTs) during screening can improve cytopathologist efficiency and may prevent diagnostic errors due to the oversights of focal findings. Here, we examine the performance of our institutional CTs when screening for Hürthle cell atypia in thyroid fine-needle aspiration (FNA) specimens. Study Design: Information on 8,814 thyroid cytopathology specimens was retrieved for a 10-year period. Specimens were screened by 1 of 11 CTs. A subsample of cases was categorized either as AUS-HC or suspicious for Hürthle cell neoplasm. Results: AUS-HC screening diagnoses were more likely to be downgraded to benign but less likely to be upgraded compared to AUS diagnoses with nuclear or microfollicular atypia. AUS-HC represents almost all papillary thyroid carcinoma (PTC) screening diagnoses downgraded to the AUS category, which suggests that even low levels of Hürthle cell atypia can result in PTC being included in the differential diagnosis. Conclusion: Overall, there are few major discrepancies between CT and pathologist diagnoses for specimens containing Hürthle cell atypia.

Cyclin D1 and D3 overexpression predicts malignant behavior in thyroid fine-needle aspirates suspicious for Hurthle cell neoplasms

2009 ◽  
pp. NA-NA ◽  
Author(s):  
Giancarlo Troncone ◽  
Marco Volante ◽  
Antonino Iaccarino ◽  
Pio Zeppa ◽  
Immacolata Cozzolino ◽  
...  
Keyword(s):  
Cyclin D1 ◽  
Fine Needle ◽  
Fine Needle Aspirates ◽  
Hürthle Cell ◽  
Malignant Behavior

Stromal Cellular Fragments in Breast Fine Needle Aspirates: Think Outside of the Box

2018 ◽  
Vol 62 (5-6) ◽  
pp. 450-455
Author(s):  
Rui Caetano Oliveira ◽  
Fernando C. Schmitt
Keyword(s):  
Differential Diagnosis ◽  
Mammary Carcinoma ◽  
Giant Cells ◽  
The Other ◽  
Low Grade ◽  
Fine Needle ◽  
Fine Needle Aspirates ◽  
Epithelial Component ◽  
Phyllodes Tumour ◽  
Epithelial Lesion

Background: The presence of highly cellular stromal fragments in breast fine needle aspirates (FNA) suggests some classical differential diagnoses such as cellular fibroadenoma, phyllodes tumour (PT), metaplastic carcinomas, and some mesenchymal/myoepithelial proliferations. The other components of the smears can help in the differential diagnosis, but the presence of a low-grade epithelial proliferation does not always represent a fibro-epithelial lesion as we demonstrate in these two cases. Cases: We discuss two cases of breast FNA, previously presented in a slide seminar at the 29th European Congress of Pathology in Amsterdam, where the common cytological finding was the presence of stromal cellular fragments together with an epithelial component. One case is a typical PT and the other is a case of a mammary carcinoma with osteoclast-like giant cells. Conclusion: Mammary carcinoma with osteoclast-like giant cells is an unusual type of breast carcinoma that should be included in the differential diagnosis of breast lesions containing cellular stroma. Since the associated carcinoma is usually low grade, careful evaluation for malignant cells on cytological smears is necessary for an accurate differential diagnosis with PT where the epithelial component is benign.

Should “Indeterminate” Diagnoses Be Used for Thyroid Fine-Needle Aspirates of Nodules Smaller Than 1 cm?

2013 ◽  
Vol 137 (11) ◽  
pp. 1627-1629 ◽  
Author(s):  
Andrew A. Renshaw ◽  
Edwin W. Gould
Keyword(s):  
Papillary Carcinoma ◽  
Follicular Cells ◽  
Fine Needle ◽  
Fine Needle Aspirates ◽  
Hürthle Cell ◽  
Cell Neoplasm ◽  
Risk Of Malignancy ◽  
Bethesda System ◽  
The Bethesda System ◽  
Undetermined Significance

Context.—The Bethesda System for thyroid fine-needle aspirates does not account for the size of the lesion that is aspirated. Objective.—To determine whether the size of the lesion would be helpful in order to reduce indeterminate thyroid aspirations. Design.—We correlated the results of all thyroid aspirations and surgical resection for the last 16 years at our institutions. Results.—A total of 9080 cases were aspirated and 1393 resections were performed. Of those resected, a total of 236 (17%) were classified as atypical follicular cells of undetermined significance, and 256 (18%) were classified as suspicious for a follicular/Hürthle cell neoplasm. A total of 52 incidental papillary carcinomas were identified in these indeterminate cases at resection (52 of 492; 11%). Thirty-seven (16%) atypical follicular cells of undetermined significance cases and 21 (8%) suspicious for a follicular/Hürthle cell neoplasm cases were for nodules smaller than 1 cm in diameter. When cases subtyped as atypical, a papillary carcinoma cannot be ruled out, were removed (13 cases), the remaining 24 and 21 aspirates identified 3 tumors each (13% and 14%), all papillary carcinomas. Together, the incidence of identified carcinomas was not significantly different than that of incidental carcinomas (13% versus 11%, P = .48). The rate of identified carcinomas was significantly less than for similar indeterminate cases smaller than 1 cm (excluding cases of atypical, papillary carcinoma cannot be ruled out) (88 of 330 cases; 27%; P = .05). Conclusions.—For nodules smaller than 1 cm in our series, indeterminate aspirates without features of papillary carcinomas have the same risk of malignancy as benign aspirates.

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