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Thyroid nodules with Hürthle cells: the malignancy risk in relation to the FNA outcome category.

Authors
  • Słowińska-Klencka, D1
  • Wysocka-Konieczna, K2
  • Woźniak-Oseła, E2
  • Sporny, S2
  • Popowicz, B2
  • Sopiński, J3
  • Kaczka, K3
  • Kuzdak, K4
  • Pomorski, L4
  • Klencki, M2
  • 1 Department of Morphometry of Endocrine Glands, Chair of Endocrinology, Medical University of Lodz, Pomorska Str 251, 92-213, Lodz, Poland. [email protected] , (Poland)
  • 2 Department of Morphometry of Endocrine Glands, Chair of Endocrinology, Medical University of Lodz, Pomorska Str 251, 92-213, Lodz, Poland. , (Poland)
  • 3 Department of Endocrinological, General and Oncological Surgery, Chair of Endocrinology, Medical University of Lodz, Pabianicka Str 62, 91-513, Lodz, Poland. , (Poland)
  • 4 Department of General and Oncological Surgery, Chair of Surgical Clinical Sciences, Medical University of Lodz, Pomorska Str 251, 92-213, Lodz, Poland. , (Poland)
Type
Published Article
Journal
Journal of Endocrinological Investigation
Publisher
Springer-Verlag
Publication Date
Nov 01, 2019
Volume
42
Issue
11
Pages
1319–1327
Identifiers
DOI: 10.1007/s40618-019-01055-0
PMID: 31077094
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The aim was to find whether the presence of Hürthle cells (HC) in a smear influences the categorization of FNA results or the risk of malignancy (RoM) of particular categories of cytological diagnosis. 25,220 FNA performed in a single center in years 2005-2017 were analyzed. Almost all the examined patients were exposed to moderate iodine deficiency for most of their lives. The distribution of FNA outcome categories was compared between two groups: with or without HC (HC and non-HC). The RoM was evaluated on the basis of postoperative histopathological examination (3082 patients). HC were found in 7.5% of diagnostic FNA. HC nodules were classified into categories II (78.2% vs. 91.9%, p < 0.0000) and VI (0.4% vs. 1.2%, p = 0.0017) less often than non-HC nodules, but more frequently to categories III (14.4% vs. 5.8%, p < 0.0000), IV (11.2% vs. 0.9%, p < 0.0000) and V (1.5% vs. 0.8%, p = 0.0013). There were no significant differences in RoM between HC and non-HC nodules. The RoM in HC and non-HC nodules of particular categories of the Bethesda system was as follows: II: 1.8% vs. 0.8%, III: 9.7% vs. 3.8% when only the last FNA was considered and 10.8% vs. 6.4% when the category III in any performed FNA was considered; IV: 12.7% vs. 10.9%; V: 41.7% vs. 58.2%; and VI: 100% vs. 96.9%. HC nodules are classified into categories of equivocal cytological outcomes more often than nodules without HC. Nevertheless, the presence of HC in a smear does not significantly affect the RoM of FNA categories.

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