title: Thyroid FNAC containing hürthle cells and hürthle-like cells: A study of 128 cases.
abstract: OBJECTIVE
  It is a diagnostic challenge to differentiate benign and malignant cytology in the presence of Hürthle cells. In our previous study, it was determined that in fine needle aspirations (FNA), the malignancy outcome of the Hürthle cells containing group tend to be papillary thyroid carcinoma (PTC) in a higher percentage. The most common misinterpretation is caused by PTC cells with large cytoplasm-like Hürthle cells. The aim of this study is to predict histologic outcome of the nodules, which have Hürthle cells in FNA according to cytological, clinical features, andBRAFV600Emutation status.
  
  
  METHODS
  Detailed cytological features of 128 cases were compared with histopathological diagnosis. The analysis ofBRAFV600Emutation of the PTC cases were performed by real-time polymerase chain reaction.
  
  
  RESULTS
  The neoplastic outcome was increased statistically significantly with younger age (P= 0.020), increase in cellular dyshesion (P= 0.016), presence of nuclear budding (P= 0.046), and granular chromatin (P= 0.003). Nuclear budding (P= 0.014), granular chromatin (P= 0.012), and hypoechoic nodules in ultrasonography (P= 0.011) were significant independent factors for the increase in the malignancy risk. Increased lymphocytes (P= 0.015) and colloid were related to non-neoplastic outcome. According to the surgical outcome, more than half of the malign cases were PTC (74%).BRAFV600Emutation was detected in 27.8% of the PTC cases.
  
  
  CONCLUSIONS
  PTC cases containing Hürthle cell-like cells may lead to diagnostic errors. Nuclear budding and granular chromatin of Hürthle cells are significant, remarkable findings to predict the outcome of neoplasm and malignancy.
authors.affiliation: Department of Pathology, Ankara Ataturk Research and Training Hospital, Ankara, Turkey.
authors.forename: Aylin
authors.initials: A
authors.lastname: Yazgan
authors.affiliation: Department of Pathology, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Balci
authors.affiliation: Department of Pathology, Ankara Ataturk Research and Training Hospital, Ankara, Turkey.
authors.forename: Nazmiye
authors.initials: N
authors.lastname: Dincer
authors.affiliation: Department of General Surgery, Guven Hospital, Ankara, Turkey.
authors.forename: Pamir Eren
authors.initials: PE
authors.lastname: Ersoy
authors.affiliation: Department of Endocrinology and Metabolism, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.
authors.forename: Dilek
authors.initials: D
authors.lastname: Tuzun
authors.affiliation: Department of Endocrinology and Metabolism, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey.
authors.forename: Reyhan
authors.initials: R
authors.lastname: Ersoy
authors.affiliation: Department of Pathology, Ankara Oncology Hospital, Ankara, Turkey.
authors.forename: Cigdem
authors.initials: C
authors.lastname: Irkkan
authors.affiliation: Department of Endocrinology and Metabolism, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey.
authors.forename: Bekir
authors.initials: B
authors.lastname: Cakir
authors.affiliation: Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Gulnur
authors.initials: G
authors.lastname: Guler
keywords: Hürthle cell; fine needle aspiration; thyroid