title: The predictive value of the fine-needle aspiration diagnosis "suspicious for a follicular neoplasm, hurthle cell type" in patients with hashimoto thyroiditis.
abstract: A fine-needle aspiration sample composed exclusively of Hürthle cells is interpreted as "suspicious for a follicular neoplasm, Hürthle cell type" (SFNHCT). Because some nonneoplastic Hürthle cell proliferations in Hashimoto thyroiditis (HT) mimic this cytologic pattern, we examined the positive predictive value (PPV) for malignancy of SFNHCT in patients with HT. Between 1992 and 2007, 401 patients with cytologic findings of SFNHCT were identified at 3 institutions. Histologic follow-up was available for 287 (71.6%), and malignancy was diagnosed in 69 (24.0%). Malignancy was present in 2 (PPV = 9.5%) of 21 patients with HT compared with 67 (PPV = 25.2%) of 266 patients without HT (P = .081). Although the difference in the rate of malignancy between the HT and non-HT cohorts did not reach statistical significance, the lower risk of malignancy in the HT cohort more closely approximates the risk of cases interpreted as "atypia of undetermined significance." For this reason, it might be appropriate for Hürthle cell-only aspirates from patients with HT to be categorized as either atypia of undetermined significance or SFNHCT.
authors.affiliation: Dept of Pathology, University of Michigan Medical School, Ann Arbor, 48109-5054, USA.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Roh
authors.forename: Vickie Y
authors.initials: VY
authors.lastname: Jo
authors.forename: Edward B
authors.initials: EB
authors.lastname: Stelow
authors.forename: William C
authors.initials: WC
authors.lastname: Faquin
authors.forename: Kelly H
authors.initials: KH
authors.lastname: Zou
authors.forename: Erik K
authors.initials: EK
authors.lastname: Alexander
authors.forename: P Reed
authors.initials: PR
authors.lastname: Larsen
authors.forename: Ellen
authors.initials: E
authors.lastname: Marqusee
authors.forename: Carol B
authors.initials: CB
authors.lastname: Benson
authors.forename: Mary C
authors.initials: MC
authors.lastname: Frates
authors.forename: Atul
authors.initials: A
authors.lastname: Gawande
authors.forename: Francis D
authors.initials: FD
authors.lastname: Moore
authors.forename: Edmund S
authors.initials: ES
authors.lastname: Cibas
mesh_terms: D018249:Adenoma, Oxyphilic; D044963:Biopsy, Fine-Needle; D049109:Cell Proliferation; D050031:Hashimoto Disease / Q000473:pathology* / Q000601:surgery; D006801:Humans; D024862:Oxyphil Cells / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D013961:Thyroid Gland / Q000473:pathology* / Q000601:surgery; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery