Hürthle cell neoplasm

A type of thyroid neoplasm

Hürthle cell neoplasm is a type of thyroid neoplasm characterized by the presence of Hürthle cells, also known as oncocytic cells. These cells are distinguished by their large size, abundant granular cytoplasm, and prominent nucleoli. Hürthle cell neoplasms can be benign (adenomas) or malignant (carcinomas).

Classification

Hürthle cell neoplasms are classified into two main types:

• Hürthle cell adenoma: A benign tumor composed predominantly of Hürthle cells. It is encapsulated and does not invade surrounding tissues.
• Hürthle cell carcinoma: A malignant tumor that can invade surrounding tissues and metastasize to other parts of the body.

Pathophysiology

Hürthle cells are derived from the follicular epithelium of the thyroid gland. They are characterized by an increased number of mitochondria, which gives them their distinctive granular appearance. The exact cause of Hürthle cell transformation is not well understood, but it is believed to involve genetic mutations and alterations in cellular metabolism.

Diagnosis

The diagnosis of Hürthle cell neoplasms typically involves a combination of clinical evaluation, imaging studies, and cytological examination.

Histopathology of a Hürthle cell adenoma

Imaging

Ultrasound is commonly used to evaluate thyroid nodules. Hürthle cell neoplasms may appear as solid, hypoechoic nodules on ultrasound.

Fine-needle aspiration

Fine-needle aspiration (FNA) is often performed to obtain a sample of the nodule for cytological analysis. However, distinguishing between benign and malignant Hürthle cell neoplasms based on FNA alone can be challenging.

Cytopathology suspicious for Hürthle cell neoplasm

Treatment

The treatment of Hürthle cell neoplasms depends on whether the tumor is benign or malignant.

• Hürthle cell adenoma: Surgical removal of the nodule is often recommended to prevent potential malignant transformation.
• Hürthle cell carcinoma: Treatment typically involves surgical resection, often followed by radioactive iodine therapy and thyroid hormone suppression therapy.

Prognosis

The prognosis for patients with Hürthle cell adenomas is generally excellent, as these tumors are benign. The prognosis for Hürthle cell carcinoma depends on the stage at diagnosis and the extent of metastasis. Early detection and treatment are crucial for improving outcomes.

Epidemiology

Hürthle cell neoplasms are relatively rare, accounting for a small percentage of all thyroid neoplasms. They are more common in older adults and have a slight female predominance.

Pie chart of relative incidences of thyroid cancers

Related pages

• Thyroid cancer
• Thyroid nodule
• Oncocytoma