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Słowińska-Klencka D, Wysocka-Konieczna K, Woźniak-Oseła E, Sporny S, Popowicz B, Sopiński J, Kaczka K, Kuzdak K, Pomorski L, Klencki M. Thyroid nodules with Hürthle cells: the malignancy risk in relation to the FNA outcome category. J Endocrinol Invest 2019; 42:1319-1327. [PMID: 31077094 PMCID: PMC6790181 DOI: 10.1007/s40618-019-01055-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 05/02/2019] [Indexed: 01/16/2023]
Abstract
PURPOSE 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. METHODS 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). RESULTS 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%. CONCLUSIONS 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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Affiliation(s)
- D Słowińska-Klencka
- Department of Morphometry of Endocrine Glands, Chair of Endocrinology, Medical University of Lodz, Pomorska Str 251, 92-213, Lodz, Poland.
| | - K Wysocka-Konieczna
- Department of Morphometry of Endocrine Glands, Chair of Endocrinology, Medical University of Lodz, Pomorska Str 251, 92-213, Lodz, Poland
| | - E Woźniak-Oseła
- Department of Morphometry of Endocrine Glands, Chair of Endocrinology, Medical University of Lodz, Pomorska Str 251, 92-213, Lodz, Poland
| | - S Sporny
- Department of Morphometry of Endocrine Glands, Chair of Endocrinology, Medical University of Lodz, Pomorska Str 251, 92-213, Lodz, Poland
| | - B Popowicz
- Department of Morphometry of Endocrine Glands, Chair of Endocrinology, Medical University of Lodz, Pomorska Str 251, 92-213, Lodz, Poland
| | - J Sopiński
- Department of Endocrinological, General and Oncological Surgery, Chair of Endocrinology, Medical University of Lodz, Pabianicka Str 62, 91-513, Lodz, Poland
| | - K Kaczka
- Department of Endocrinological, General and Oncological Surgery, Chair of Endocrinology, Medical University of Lodz, Pabianicka Str 62, 91-513, Lodz, Poland
| | - K Kuzdak
- Department of General and Oncological Surgery, Chair of Surgical Clinical Sciences, Medical University of Lodz, Pomorska Str 251, 92-213, Lodz, Poland
| | - L Pomorski
- Department of General and Oncological Surgery, Chair of Surgical Clinical Sciences, Medical University of Lodz, Pomorska Str 251, 92-213, Lodz, Poland
| | - M Klencki
- Department of Morphometry of Endocrine Glands, Chair of Endocrinology, Medical University of Lodz, Pomorska Str 251, 92-213, Lodz, Poland
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