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The prevalence and surgical outcomes of Hürthle cell lesions in FNAs of the thyroid: A multi-institutional study in 6 Asian countries

Authors
 Shipra Agarwal  ;  Andrey Bychkov  ;  Chan Kwon Jung  ;  Mitsuyoshi Hirokawa  ;  Chiung‐Ru Lai  ;  SoonWon Hong  ;  Hyeong Ju Kwon  ;  Samreung Rangdaeng  ;  Zhiyan Liu  ;  Peng Su  ;  Kennichi Kakudo  ;  Deepali Jain 
Citation
 CANCER CYTOPATHOLOGY, Vol.127(3) : 181-191, 2019 
Journal Title
 CANCER CYTOPATHOLOGY 
ISSN
 1934-662X 
Issue Date
2019
Keywords
Hürthle cell lesion ; Hürthle cell neoplasm ; Hürthle cell type ; atypia of undetermined significance/follicular lesion of undetermined significance ; fine-needle aspiration (FNA) ; follicular neoplasm ; risk of malignancy (ROM) ; risk of neoplasia (RON) ; the Bethesda System for Reporting Thyroid Cytopathology
Abstract
BACKGROUND: Hürthle cell-rich nodules (HCNs) encompass non-neoplastic to malignant lesions. There is paucity of literature on the frequency distribution of HCNs among Bethesda categories, histologic follow-up, risk of malignancy (ROM), and risk of neoplasia (RON). The objective of this retrospective, multi-institutional study was to determine the prevalence of the cytologic diagnostic category and surgical outcomes of patients with HCN. METHODS: Nine tertiary health centers representing 6 Asian countries participated. Cases were retrieved from respective databases. The Bethesda System for Reporting Thyroid Cytopathology was used. Cytology results were correlated with surgical diagnoses. RESULTS: Of 42,190 thyroid aspirates retrieved, 760 (1.8%) had a Hürthle cell predominance. Most (61%) were categorized as atypia of undetermined significance/follicular lesion of undetermined significance, Hürthle cell type" (AUS-H); 35% were categorized as follicular neoplasm, Hürthle cell type (FN-H); and 4% were categorized as suspicious for malignancy (SFM). Histologic follow-up was available for 288 aspirates (38%). Most were benign on resection (66%), and the most common histologic diagnosis was Hürthle cell adenoma (28.5%). The ROM for AUS-H, FN-H, and SFM, as calculated on resected nodules, was 32%, 31%, and 71%, respectively; and the RON was 47%, 81%, and 77%, respectively. The 5 institutions that had an AUS-H:HCN ratio below 0.5 diagnosed HCN less frequently as AUS-H than as FN-H. CONCLUSIONS: This is the largest, contemporary, multi-institutional series of HCNs with surgical follow-up. Although there was wide interinstitutional variation in prevalence and surgical outcomes, there was no significant difference in the ROM among institutions. The categories AUS-H and FN-H had a similar ROM for resected nodules.
Full Text
https://onlinelibrary.wiley.com/doi/full/10.1002/cncy.22101
DOI
10.1002/cncy.22101
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Hong, Soon Won(홍순원) ORCID logo https://orcid.org/0000-0002-0324-2414
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/169396
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