Hurthle Cells??

[TriciaS]

Hi!  I had an FNA on 03/07/08, results were positive for Papillary Adenocarcinoma.  But here's my question!  I also had an FNA in February 2005 on two large nodules, one on the right node and one on the left node.  I just picked up my records from the hospital where the FNA was done to bring to the new cancer folks.  I was reading the pathology report for the 2005 FNA and it says Occasional Hurthle cells are seen in the background, and Occasional Hurthle cells are identified in the background.

When you google Hurthle, you get thyroid cancer.  So, have any of you guys had Hurthle cells and not cancer??

I'm totally confused (which is getting to be pretty normal around here. . . )

Thanks in advance for your help figuring *this* out!!

Tricia S.  : )
(no surgery yet!)

[worriedinmd]

My FNA also showed Hurthle cells in the background. Dr said there is a better than 80% chance it's NOT cancerous. Will know for sure next week. No point in worrying. Like redheadaussie said, most aren't a big deal. Better to stay positive.

[redheadaussie]

Hi I had surgery in Dec 2007. My pathology showed Hurthle Cells and follicular cell changes into Hurthle cells. The conclusion was that it was an Oxyphilic adenoma with changes. In every day language a rather large lump with cells changing into others but not cancer as such. If you have more than 75% Hurthle Cells, they usually err on the side of caution and take the thyroid out. Cancer is defined if it has spread out of its original cell area. Hurthle cells are extremely common (as I have discovered since!) and almost 90% are NOT cancer. Yes, it is really difficult to find anything on the net about Hurthle cells without having a heart attack! But rest assured, it is NOT as bad as it seems. I think getting dosages right after surgery is 1,000 more difficult to deal with!
All the best!

[utahmomma]

Oh, here's another quote.  This one from:  http://www.emedicine.com/med/topic1045.htm

"Oncocytic cells in the thyroid are often called Hürthle cells, and oncocytic change is defined as cellular enlargement characterized by an abundant eosinophilic granular cytoplasm as a result of accumulation of altered mitochondria. This is a phenomenon of metaplasia that occurs in inflammatory disorders, such as thyroiditis, or other situations that result in cellular stress. The proliferation of oncocytes gives rise to hyperplastic and neoplastic nodules.1
   The cytological features for Hürthle cell neoplasms are hypercellularity with a predominance of Hürthle cells (usually >75%), few or no lymphocytes, and scanty or absent colloid. In 1898, Askanasy described Hürthle cells; however, they are mistakenly named for the German physiologist who actually described the interfollicular C-cell.2 Hürthle cells are large and polygonal in shape, with indistinct cell borders. They have a large pleomorphic hyperchromatic nucleus, a prominent nucleolus, and intensely pink, fine, granular cytoplasm with hematoxylin-eosin staining. Hürthle cells are also found in other tissues, such as the salivary gland, parathyroid gland, esophagus, pharynx, larynx, trachea, kidney, pituitary, and liver.
  Controversy exists about the origin of Hürthle cells, which generally are thought to derive from the follicular epithelium. A Hürthle cell neoplasm is defined generally as an encapsulated thyroid lesion consisting of at least 75% of Hürthle cells. Distinguishing a benign neoplasm from a malignant neoplasm based on cytologic analysis of fine-needle aspiration (FNA) biopsy is not possible. Features such as pleomorphism, anaplasia, hyperchromatism, and atypia are also observed in benign follicular adenomas; therefore, a definitive way to differentiate Hürthle cell carcinoma from Hürthle-cell adenoma is based on vascular invasion and/or capsular invasion, as well as on permanent histologic sections or extrathyroidal tumor spread and lymph node and systemic metastases.
  Incidence of malignancy in patients with Hürthle-cell neoplasms reported in the literature is variable. Reports show that malignancy occurs in 13-67% of patients."


Just call me Momma-Google-med-articles.  :-)

Utahmomma
papillary carcinoma '03

[utahmomma]

Here's a Harvard Med School article that I quoted in a previous post:  http://brighamrad.harvard.edu/Cases/jpnm/hcache/1091/full.html

It stated (in part):  "Hurthle cells are seen in association with a number of benign thyroid conditions including nodular hyperplasia, Graves’ disease, and thyroiditis."

[ChitChatNine]

THANKS .... no brain fog today for me LOL ...I knew it just was on the board!

C~

[dscoochie]

Hi there,
It was me who asked about hurthle cells.  If you look at my posts, you will see the one that says FNA Results and read all the responses and links to web sites that were helpful.  I have hurthle cells in my nodule.  I think if its more than 75% hurthle cells, then its called a hurthle cell lesion, otherwise, they just note it.  
A hurthle nodule can or cannot be benign, just like all nodules.  I think if it is malignant, it falls under follicular cancer with a hurthle variant or something.  I found the ****.com web site very helpful in understanding.
I hope everything works out for you.
My surgery is a week from Monday - God help me - I'm a wreck!!!
DSC

[TriciaS]

Thanks for your answer!  When did you have your tt?  Isn't this one of the most confusing things you've been through??!  My original Endo didn't take me seriously, and he had the FNA results and didn't tell me about the Hurthle cells.  It seems to me that at the very least, I should have been biopsied once a year (not something I would enjoy!) to make sure the Hurthle cells haven't turned into cancer?  I can't figure out how this works. . . I switched Endos, the new one ordered a new FNA on a different nodule, and that's when I got the Papillary Adenocarcinoma diagnosis.

Sorry for ranting. . . Crazy!!

Thanks again,
Tricia
: )

[TriciaS]

Hi,

Thanks for your reply!  I just figured out how to search the archives.  Of course, all the answers there are also very confusing. . . I guess I'll have to wait and talk with the surgeon.  Hurry up and wait!  I hate waiting, because I don't seem to be living in the moment, enjoying myself & my children the way I should.  I'm consumed with this mess.  Oh well.  Monday is right around the corner.  Wait until my surgery is scheduled. . . I'll be a wreck!

Thanks again,

Tricia
: )

[redhed87]

I had cancer on one side(2.65cm) and after my tt my final pathology came back as one 2 nodules cancerous (multifocal)  and the other side was an adenoma that had hurthle cells but no evidence of carcinoma.  I think it is a pre cursor maybe to cancer?  I always thought hurthle meant cancer, but I guess not.

[ChitChatNine]

I think a poster just a few days ago, even yesterday maybe?, mentioned they can or cannot be cancerous in nature ?

I am sorry for your new FNA results.  I am glad you have an answer and you caught this nodule now.

Wish I could give you more info, but I am not a Hurthle Cell expert ... mine were papillary microcarcinomas .. small .. only mm's.

Cheryl