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thyroid oncocytic carcinoma

Friday 7 December 2007

invasive Hurthle cell carcinoma; Hurthle cell carcinoma; thyroid oxpyphilic carcinoma; oncocytic thyroid follicular carcinoma (Hürthle cell variant of follicular carcinoma); thyroid oncocytic follicular carcinoma

Digital cases

- JRC:329 : Poorly differentiated Hurthle cell carcinoma.
- JRC:14583 : Minimally invasive Hurthle cell carcinoma.
- JRC:14616 : Minimally invasive Hurthle cell carcinoma.
- JRC:15036 : Follicular carcinoma with Hurthle cell features (Hurthle cell carcinoma).
- JRC:18761 : Hurthle cell carcinoma of the thyroid, metastatic to vertebrae.
- JRC:18922 : Hurthle cell carcinoma (oxyphilic cell carcinoma) (F, 80 y/o, Right lobe of Thyroid).
- JRC:18911 : Hurthle cell carcinoma (Follicular carcinoma, oxyphilic cell type).

Synopsis

- Hurthle cell thyroid cancer is often considered a variant of follicular cell carcinoma.
- Hurthle cell forms are more likely than follicular carcinomas to be bilateral and multifocal and to metastasize to lymph nodes.
- Like follicular carcinoma, unilateral hemithyroidectomy is performed for non-invasive disease, and total thyroidectomy for invasive disease.
- These have been thought to be intrinsically more aggressive than other follicular carcinomas but the consensus view is that these lesions behave similarly according to their invasiveness, grade and stage.
- Hürthle cell or oncocytic variants of follicular carcinoma constitute approximately 5% of the total.
- They show different genetic alterations to usual follicular carcinomas.
- They do not take up radioactive iodine well and hence treatment may be less successful.
- Hürthle cell tumours may undergo clear cell change caused by swelling of the numerous mitochondria which they contain and this is one of the derivations of clear cell variants of follicular carcinoma.

Oncocytic follicular carcinomas have a variety of architectural patterns. They may form follicles that tend to be uniform in size throughout the lesion, and the most common pattern is microfollicular with scant colloid. However, most of these lesions have a pattern of solid and/or trabecular growth and are generally devoid of colloid.

As with other follicular carcinomas, malignancy is based on the identification of invasion that may be minimal, obvious, or widespread.

Vascular invasion warrants identification with specific classification as angioinvasive carcinoma. The criteria are not different from those applied to follicular carcinoma.

Variants

- poorly differentiated oncocytic thyroid carcinoma (22348590)

See also

- thyroid oncocytic tumors

  • thyroid oncocytic adenoma
  • thyroid oncocytic carcinoma

References

- Poorly differentiated oncocytic thyroid carcinoma—diagnostic implications and outcome. Dettmer M, Schmitt A, Steinert H, Moch H, Komminoth P, Perren A. Histopathology. 2012 Jun;60(7):1045-51. PMID: 22348590

- Bonora E, Evangelisti C, Bonichon F, Tallini G, Romeo G. Novel germline variants identified in the inner mitochondrial membrane transporter TIMM44 and their role in predisposition to oncocytic thyroid carcinomas.Br J Cancer. 2006 Dec 4;95(11):1529-36. PMID: 17088905

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