title: The diagnostic accuracy of fine-needle cytology of Hurthle cell lesions; A comprehensive cytological, clinical and ultrasonographic experience.
abstract: BACKGROUND
  Fine-needle cytology (FNC) diagnosis and pre-operative classification of Hurthle cells (HC) lesions may be difficult. Rapid on-site evaluation (ROSE) enhances the efficiency of FNC, mainly when utilized in close combination to clinical and ultrasound (US) data.
  
  
  OBJECTIVE
  to describe an experience on HC FNC with contextual clinical,US and ROSE evaluation and assess if this comprehensive approach improves the FNC accuracy of HC lesions.
  
  
  METHODS
  FNC of 112 HC lesion were diagnosed and classified, according to the Bethesda system, by clinical, US and ROSE in one year. All the cases were controlled by follow-up and histology when performed.
  
  
  RESULTS
  Eighty-five cases were diagnosed HC rich goiter or Hashimoto thyroiditis and were classified THY2; 5 cases were diagnosed hyperplastic nodular goiter and classified THY3A. Eight cases were diagnosed suspect neoplasia and classified THY3B. Two cases were diagnosed suspect HC papillary thyroid carcinoma (PTC) and classified THY4 and 2 cases were diagnosed HC-PTC and classified THY5. THY3B, THY4, THY5 and 1 THY3A were histologically controlled. FNC were confirmed in 14 out of the 17 THY3-THY5 cases.
  
  
  CONCLUSIONS
  A comprehensive diagnostic approach that include FNC, clinical data, US and ROSE improves the diagnosis and classification of HC lesions.
authors.affiliation: Azienda Ospedaliera Universitaria "San Giovanni di Dio e Ruggi d'Aragona", Department of Medicine and Surgery, University of Salerno, Italy. Electronic address: alessia.caleo@sangiovannieruggi.it.
authors.forename: Alessia
authors.initials: A
authors.lastname: Caleo
authors.affiliation: Azienda Ospedaliera Universitaria "San Giovanni di Dio e Ruggi d'Aragona", Department of Medicine and Surgery, University of Salerno, Italy. Electronic address: luigi.landolfi@inwind.it.
authors.forename: Luigi
authors.initials: L
authors.lastname: Landolfi
authors.affiliation: Azienda Ospedaliera Universitaria "San Giovanni di Dio e Ruggi d'Aragona", Department of Medicine and Surgery, University of Salerno, Italy. Electronic address: mavitale@unisa.it.
authors.forename: Mario
authors.initials: M
authors.lastname: Vitale
authors.affiliation: Azienda Ospedaliera Universitaria "San Giovanni di Dio e Ruggi d'Aragona", Department of Medicine and Surgery, University of Salerno, Italy. Electronic address: vdicrescenzo@unisa.it.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Di Crescenzo
authors.affiliation: Azienda Ospedaliera Universitaria "San Giovanni di Dio e Ruggi d'Aragona", Department of Medicine and Surgery, University of Salerno, Italy. Electronic address: avatrella@unisa.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Vatrella
authors.affiliation: University of Naples "Federico II", Italy. Electronic address: gaderosa@unina.it.
authors.forename: Gaetano
authors.initials: G
authors.lastname: De Rosa
authors.affiliation: Azienda Ospedaliera Universitaria "San Giovanni di Dio e Ruggi d'Aragona", Department of Medicine and Surgery, University of Salerno, Italy. Electronic address: annalucia.peluso@gmail.com.
authors.forename: Anna Lucia
authors.initials: AL
authors.lastname: Peluso
authors.affiliation: Azienda Ospedaliera Universitaria "San Giovanni di Dio e Ruggi d'Aragona", Department of Medicine and Surgery, University of Salerno, Italy. Electronic address: pzeppa@unisa.it.
authors.forename: Pio
authors.initials: P
authors.lastname: Zeppa
mesh_terms: D018249:Adenoma, Oxyphilic / Q000145:classification / Q000000981:diagnostic imaging / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D002291:Carcinoma, Papillary / Q000145:classification / Q000000981:diagnostic imaging / Q000473:pathology; D006044:Goiter, Nodular / Q000145:classification / Q000000981:diagnostic imaging / Q000473:pathology; D050031:Hashimoto Disease / Q000145:classification / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D006965:Hyperplasia; D008297:Male; D008875:Middle Aged; D013964:Thyroid Neoplasms / Q000145:classification / Q000000981:diagnostic imaging / Q000473:pathology*; D016606:Thyroid Nodule / Q000145:classification / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography; D055815:Young Adult
keywords: Fine needle cytology; Hurthle cells; Rapid on-site evaluation; Ultrasound