Hürthle cell metaplasia on fine-needle aspiration biopsy is not by itself an indication for thyroid surgery

Am J Surg. 2012 Mar;203(3):287-90; discussion 290-1. doi: 10.1016/j.amjsurg.2011.09.019. Epub 2012 Jan 20.

Abstract

Introduction: The aim of this study was to assess the malignancy rate in patients with Hürthle cell metaplasia (HCM) on fine-needle aspiration biopsy (FNAB).

Methods: The pathology results of patients with benign colloid (BC) and HCM on FNAB were compared using a prospective database.

Results: One hundred fifty-three (65%) patients had BC on FNAB, and 82 (35%) had HCM. The mean nodule size was similar in both groups (25 ± 2 mm vs 26 mm ± 2 mm, P = .83). Malignancy was identified on the final pathology report in 21 (14%) versus 13 (16%) patients in the BC and HCM groups, respectively (P = .66). Of the patients with malignancy, the tumor was determined as microcarcinoma in 76% in the BC groups versus 85% in the HCM group (P = .48) and as incidental in 71% versus 85% (P = .39).

Conclusions: A result of HCM on FNAB carries a similar rate of malignancy as BC and should not be treated differently. Most of the malignancies found were incidental microcarcinomas.

Publication types

  • Evaluation Study

MeSH terms

  • Adenoma, Oxyphilic
  • Biopsy, Fine-Needle
  • Colloid Cysts / pathology
  • Female
  • Humans
  • Male
  • Metaplasia
  • Middle Aged
  • Oxyphil Cells / pathology*
  • Retrospective Studies
  • Thyroid Gland / pathology*
  • Thyroid Gland / surgery
  • Thyroid Neoplasms / pathology*
  • Thyroid Neoplasms / surgery
  • Thyroidectomy*

Supplementary concepts

  • Thyroid cancer, Hurthle cell