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Fine-Needle Aspiration Biopsy of Hürthle Cell Neoplasms of the Thyroid

Bernadt, Cory T. MD, PhD; Collins, Brian T. MD

doi: 10.1097/PCR.0000000000000090
Case Reviews

Fine-needle aspiration (FNA) biopsy of Hürthle cell containing thyroid nodules can be challenging because of a broad differential that contains both benign and malignant entities. Most nodules diagnosed by FNA as a follicular neoplasm, Hürthle cell type, are benign. This results in unnecessary surgeries and the risk of complications that accompany it. Numerous studies have tried to determine the most useful cytomorphologic features to best make the distinction between benign and malignant Hürthle cell nodules. While there are reproducible cytomorphologic features that can favor one over the other, there does not appear to be a single cytologic feature that can entirely exclude a neoplasm. While morphologically Hürthle cell carcinoma is considered a variant of follicular carcinoma, there is evidence to support it may be a distinct entity. In the future, molecular studies might be able to complement the cytomorphologic findings of FNA to provide a more refined and specific diagnosis for Hürthle cell containing thyroid nodules.

From the Department of Pathology & Immunology, Washington University School of Medicine, St Louis, MO.

Reprints: Cory T. Bernadt, MD, PhD, Department of Pathology & Immunology, Washington University School of Medicine, Campus Box 8118, 660 South Euclid Ave, St Louis, MO 63110. E-mail:

The authors have no funding or conflicts to declare.

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