Endocrine Pathology Online
Pathology of Hurthle Cell (Oxyphil) Carcinoma of the Thyroid
Hurthle cells have
voluminous eosinophilic cytoplasm rich in mitochondria as
evidenced by special stains and electron microscopy.
It was once thought that thyroid neoplasms comprising these cells were of
unpredictable behaviour and should be termed Hurthle cell "tumours".
It is now known that the defining criteria for malignancy are exactly the same as for
follicular neoplasms in general.
Hurthle cell tumours are more likely than ordinary follicular neoplasms to show
invasion and thorough sampling of Hurthle cell neoplasms is therefore important.
They are also more likely to show tumour necrosis.
Any cystic necrotic thyroid tumour should be carefully searched for Hurthle cell
They are more aggressive than standard follicular carcinoma and unlike it may
metastasize to lymph nodes.
The finding of apparent follicular carcinoma in a lymph node should always prompt
consideration that it may be:
(1) Follicular variant Papillary Carcinoma and
(2) Hurthle cell carcinoma.
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