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Dr. Andrew Rynne

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What does oncocytic and hurthle cell features mean?

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Dr. Ganesh Sanap

Radiologist

Practicing since :2007

Answered : 561 Questions

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Posted on Tue, 8 Jan 2013 in Cancer
Question: Just received a copy of thyroid biopsy. What does oncocytic / hurtlhle cell features mean.
doctor
Answered by Dr. Ganesh Sanap 3 hours later
Hi XXXXXXX
Thanks for writing in.
Hurtlhe cells are seen in both neoplastic and non neoplastic conditions. It is seen in hurthle cell carcinoma, neoplastic condition and hashimotos thyroiditis , a non neoplastic condition.
The overall diagnosis depends on details of cell morphology seen on biopsy. Also if there is any nodule or mass in thyroid, then chances of neoplasm are high. If possible, please upload your sonography reports. It will definitely help for diagnosis.
Also please let me know your symptoms.
I look forward to hearing from you

Above answer was peer-reviewed by : Dr. Aparna Kohli
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Follow up: Dr. Ganesh Sanap 6 hours later
Right thyroid nodule fine needle aspiration cytology. Papillary carcinoma of the thyroid with oncocytic/hurtlhle cell features. General categorization. Positive for malignacy
8*8*7 hypoechoic nodule mid portion of right lobe specimen right lobe

Cytology preparation appears highly cellular and contains groups and sheets of large epithelial cells demonstrating marked nuclear pleomorphism, high n/c ratios and frequent optically clear nuclei. Focal papillary architecture is present. Several nuclear inclusions and frequent nuclear grooves are seen. An occasional mitotic figue is noted.
The majority of of large cells contain finely granular eosinophilia consistent with oncocytic/hurtlhle cell change. Colloid is not identified.

I understand the nodule to be quite small even though it has grown

My symptoms other being tired but not sleeping and messed up swallowing sometimes wouldn't be thyroid related I get winded a little easier now and my left side rib cage area feels uncomfortable ..... Possibly scar tissue from previous thoracic surgery and my joints and right leg often uncomfortable. Nothing so bad that it keeps me from working.
What is colloid? Any good questions I should ask my doctor when I see him in two weeks. If surgery is required is as an out patient
doctor
Answered by Dr. Ganesh Sanap 2 hours later
Hi,

The updated biopsy report unfortunately suggests it is a neoplastic condition. I am afraid it is suggesting of a malignancy.

Colloid means a normal thyroid parenchyma which is increased in size. It absence is not a good sign.

In view of these findings, you have to undergo one more operation. You must ask your doctor to do detail work up to rule out metastasis. Because hurtle cell carcinoma has high rate of metastasis. Accordingly treatment plan will change - either radiotherapy or operation.

At this instant I suggest you to be strong to face the situation. Consulting an oncologist is warranted.

Let me know if you need further guidance.

Good luck!!

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Ganesh Sanap 3 hours later
Do you think I could ask for a cat scan or should it be an MRI. Which one lets you know if it has mestasised and where or would a blood test be able to tell more. It is so great that there is a site like this to help. Waiting two weeks to see the dr would be a lot harder. Am I right in thinking this isn't the more common type of thyroid cancer that everyone says is the better kind of cancer if you were going to have one? I'm waiting to tell my husband till after the holidays so also thanks for being a sounding board
doctor
Answered by Dr. Ganesh Sanap 40 minutes later
Hi,

1. We can perform a MRI of the brain, spine study and neck. Depending on availability and affordability, PET scan will be best option to know the minor metastasis. Blood tests are of no much help.

2. You are right about the type of cancer. It has better prognosis when compared to follicular carcinoma (the other type of thyroid cancer).

I will be glad to assist you further should you have other concerns.

Best Regards

Above answer was peer-reviewed by : Dr. Prasad
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