Thyroid Oncocytic (Hürthle Cell) Nodules With Longitudinal Nuclear Grooves: Clinicopathologic, Immunohistochemical, and Molecular Genetic Study of 15 Cases.

Context.--Thyroid nodules with longitudinal nuclear grooves have been widely regarded as synonymous with papillary thyroid carcinoma (PTC). Objective.--To study a series of cases of thyroid nodules that exhibited oncocytic (Hürthle cell) features and contained longitudinal nuclear grooves yet failed...

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Published in:Archives of Pathology & Laboratory Medicine Vol. 147; no. 6; pp. 684 - 692
Main Authors: Suster, David, Mackinnon, Alexander Craig, Suster, Saul
Format: pictorial research tables/charts Journal Article
Published: College of American Pathologists Jun2023
Online Access:View this record in EBSCOhost
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      dt: Jun2023
      vid: 147
      iid: 6
      pid: 2550
      pub: College of American Pathologists
      place: Northfield, Illinois
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        164038380
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        10.5858/arpa.2021-0554-OA
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        atl: Thyroid Oncocytic (Hürthle Cell) Nodules With Longitudinal Nuclear Grooves: Clinicopathologic, Immunohistochemical, and Molecular Genetic Study of 15 Cases.
      aug:
        au:
          Suster, David
          Mackinnon, Alexander Craig
          Suster, Saul
        affil: Department of Pathology, Rutgers University Medical School, Newark, New Jersey
      sug:
        subj:
          Adenoma Symptoms
          Thyroid Nodule Symptoms
          Disease Attributes
          Adenoma Pathology
          Thyroid Nodule Pathology
          Immunohistochemistry
          Molecular Biology
          Adenoma Familial and Genetic
          Thyroid Nodule Familial and Genetic
          Human
          Sequence Analysis
          Gene Expression Profiling
          Male
          Female
          Adult
          Middle Age
          Aged
          Aged, 80 and Over
          After Care
          Carcinoma, Papillary Diagnosis
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Context.--Thyroid nodules with longitudinal nuclear grooves have been widely regarded as synonymous with papillary thyroid carcinoma (PTC). Objective.--To study a series of cases of thyroid nodules that exhibited oncocytic (Hürthle cell) features and contained longitudinal nuclear grooves yet failed to display aggressive behavior or the full features of papillary thyroid carcinoma. Design.--The clinicopathologic, immunohistochemical, and molecular genetic features of 15 patients with these features were studied. Next-generation sequencing was performed to examine 161 genes for oncogenic driver alterations associated with thyroid neoplasia. Results.--The lesions occurred in 11 women and 4 men aged 27 to 80 years and measured 0.2 to 2.3 cm in diameter (mean, 1.1 cm). The tumors were well circumscribed and noninvasive and showed a proliferation of large cells with abundant granular cytoplasm and centrally placed nuclei displaying scattered longitudinal nuclear grooves. Immunohistochemical stains were negative for HBME-1, galectin-3, and CK19 in all cases. NRAS pQ61R was detected in 6 cases, KRAS p.Q61E in 1 case, and AKT2 p.E17K in 1 case. None of the genetic changes classically associated with conventional PTC or with high-grade thyroid malignant neoplasms were identified. Clinical follow-up in 9 patients showed no evidence of recurrence or metastases between 2 and 13 years (mean, 5.7 years). Conclusions.--Longitudinal nuclear grooves can be occasionally encountered in oncocytic (Hürthle cell) tumors and should not lead to a diagnosis of PTC in the absence of other features supporting that diagnosis.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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