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Thyroid Hürthle Cell Carcinoma: Clinical, Pathological, and Molecular Features

Integrated Diagnostic Pathology, Nippon Medical School, 1-1-5 Sendagi, Bunkyoku, Tokyo 113-8602, Japan
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Cancers 2021, 13(1), 26; https://doi.org/10.3390/cancers13010026
Received: 18 November 2020 / Revised: 11 December 2020 / Accepted: 22 December 2020 / Published: 23 December 2020
(This article belongs to the Special Issue 2020 Update on the Management of Thyroid Cancer)
Hürthle cell carcinoma (HCC) represents 3–4% of thyroid carcinoma cases. It is characterized by its large, granular and eosinophilic cytoplasm, due to an excessive number of mitochondria. Hürthle cells can be identified only after fine needle aspiration cytology biopsy or by histological diagnosis after the surgical operation. Published studies on HCC indicate its putative high aggressiveness. In this article, current knowledge of HCC focusing on clinical features, cytopathological features, genetic changes, as well as pitfalls in diagnosis are reviewed in order to improve clinical management.
Hürthle cell carcinoma (HCC) represents 3–4% of thyroid carcinoma cases. It is considered to be more aggressive than non-oncocytic thyroid carcinomas. However, due to its rarity, the pathological characteristics and biological behavior of HCC remain to be elucidated. The Hürthle cell is characterized cytologically as a large cell with abundant eosinophilic, granular cytoplasm, and a large hyperchromatic nucleus with a prominent nucleolus. Cytoplasmic granularity is due to the presence of numerous mitochondria. These mitochondria display packed stacking cristae and are arranged in the center. HCC is more often observed in females in their 50–60s. Preoperative diagnosis is challenging, but indicators of malignancy are male, older age, tumor size > 4 cm, a solid nodule with an irregular border, or the presence of psammoma calcifications according to ultrasound. Thyroid lobectomy alone is sufficient treatment for small, unifocal, intrathyroidal carcinomas, or clinically detectable cervical nodal metastases, but total thyroidectomy is recommended for tumors larger than 4 cm. The effectiveness of radioactive iodine is still debated. Molecular changes involve cellular signaling pathways and mitochondria-related DNA. Current knowledge of Hürthle cell carcinoma, including clinical, pathological, and molecular features, with the aim of improving clinical management, is reviewed. View Full-Text
Keywords: Hürthle cell carcinoma; thyroid cancer; oncocytic Hürthle cell carcinoma; thyroid cancer; oncocytic
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MDPI and ACS Style

Kure, S.; Ohashi, R. Thyroid Hürthle Cell Carcinoma: Clinical, Pathological, and Molecular Features. Cancers 2021, 13, 26. https://doi.org/10.3390/cancers13010026

AMA Style

Kure S, Ohashi R. Thyroid Hürthle Cell Carcinoma: Clinical, Pathological, and Molecular Features. Cancers. 2021; 13(1):26. https://doi.org/10.3390/cancers13010026

Chicago/Turabian Style

Kure, Shoko, and Ryuji Ohashi. 2021. "Thyroid Hürthle Cell Carcinoma: Clinical, Pathological, and Molecular Features" Cancers 13, no. 1: 26. https://doi.org/10.3390/cancers13010026

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