Hürthle cell carcinoma

Abstract

The Hürthle cell variant of follicular carcinoma is composed of large acidophilic, Askanazy, or oncocytic cells that are considered altered follicular cells (1,2). For instance, Hürthle cells bind thyrotropin (TSH) and have TSH receptors, like other types of follicular thyroid cells (3,4). Similar to other follicular neoplasms, Hürthle cell carcinoma is more common in women than men, but the patients tend to be older than those with typical follicular thyroid carcinoma (FTC; see Chapter 55). Hürthle cells contain many mitochondria (which are the basis for the abundant, eosinophilic, and granular cytoplasm), frequently eccentric nuclei, and visible nucleoli. The Hürthle cell carcinoma variant of follicular carcinoma discussed here is to be distinguished from the variant of papillary thyroid cancer, Hürthle cell papillary thyroid carcinoma,which also contains an abundance of oxyphilic cells (4a). The central genetic or environmental factors that allow a thyrocyte to differentiate into a Hürthle cell are unknown, and Hürthle cells may occur in a variety of thyroid disorders. Solitary thyroid nodules may have a predominance of Hürthle cells, to the exclusion of more typical thyrocytes, and these lesions are often highly cellular with minimal colloid. © 2006 Humana Press Inc.