VALUE OF FINE-NEEDLE ASPIRATION IN THE DIAGNOSIS OF HURTHLE CELL NEOPLASMS

The cytologic and histologic slides on all patients with a diagnosis o f Hurthle cell tumor at Mount Sinai Hospital during the last 12 years were reviewed. There were 67 Hurthle cell tumors of which 15 (22%) wer e malignant. Four carcinomas (27%) occurred in a background of thyroid itis. Forty-three patients with Hurthle cell tumors had undergone preo perative fine-needle aspiration, of which 31 had satisfactory aspirate s. For Hurthle cell neoplasia, fine-needle aspiration cytology had a s ensitivity of 83.8% (26 of 31) and positive predictive value of 93% (2 6 of 28), provided that the aspirate was of adequate cellularity. All 3 cases predicted as Hurthle cell carcinoma on the basis of cellular a nd nuclear atypia were correctly predicted, but 3 carcinomas composed of bland cells were incorrectly predicted as adenomas. We conclude tha t aspiration cytology can differentiate nonneoplastic from neoplastic Hurthle cell lesions with high accuracy, but that the differentiation between benign and malignant lesions is less reliable.