Endocrinol Metab.  2010 Dec;25(4):316-320. 10.3803/EnM.2010.25.4.316.

Postoperative Findings of the Cytological Diagnosis of Follicular Neoplasm or Hurthle Cell Neoplasm and the Risk of Malignancy

• Yim JH
• Kim EY
• Kim WG
• Kim TY
• Gong G
• Hong SJ
• Kim WB
• Shong YK

• KMID: 1497757
• DOI: http://doi.org/10.3803/EnM.2010.25.4.316

Abstract

BACKGROUND
Follicular neoplasm (FN) or Hurthle cell neoplasm (HN) is a less well understood pitfall when evaluating thyroid nodule with fine-needle aspiration (FNA). This study aimed to determine the rates of malignancy and the predictive factors for malignancy in thyroid nodules with a cytological diagnosis of FN or HN.
METHODS
The patients who were cytologically diagnosed as having FN or HN after FNA between 1995 and 2004 at Asan Medical Center were included in this study. We collected the pathology data until 2009 and we analyzed the clinical characteristics associated with malignancy.
RESULTS
A total 478 patients were cytologically diagnosed as having FN or HN during the study period and 327 (68%) among them underwent thyroid surgery. Thyroid malignancy was confirmed in 157 (48%) of 327 patients. Malignancy was confirmed in 124 patients with FN (124/253, 49%). They were 48 papillary, 65 follicular, 7 Hurthle cell and 3 medullary carcinomas and 1 anaplastic carcinoma. The malignancy in the cases of HN (33/71, 44.6%) was 9 papillary, 4 follicular and 20 Hurthle cell carcinomas. The risk of malignancy was not associated with male gender, a larger tumor size (> 4 cm) or the diagnosis of HN. However, an age below 20 years (RR 3.6, P = 0.03) and above 60 years (RR 2.3, P = 0.04) was associated with an increased risk of malignancy.
CONCLUSION
About half of the patients with FN or HN on FNA cytology were diagnosed as having thyroid cancer after surgery. The malignancy rate for the cytologic diagnosis of HN was similar to that for FN. Thyroid surgery should be recommended for this situation, and especially for patients younger than 20 years or older than 60 years.

Keyword

Cytology; Follicular neoplasm; Hurthle cell neoplasm; Thyroid cancer

MeSH Terms

Biopsy, Fine-Needle
Carcinoma
Carcinoma, Medullary
Humans
Male
Thyroid Gland
Thyroid Neoplasms
Thyroid Nodule

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