{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T15:48:07Z","timestamp":1791042487285,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,11,21]],"date-time":"2019-11-21T00:00:00Z","timestamp":1574294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Cytopathology"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>H\u00fcrthle cell metaplasia is common in hyperplastic nodules, particularly within the setting of lymphocytic thyroiditis (LT). The Bethesda System for Reporting Thyroid Cytopathology indicates that it is acceptable to classify H\u00fcrthle cell\u2013predominant fine\u2010needle aspiration (HC FNA) specimens as atypia of undetermined significance (AUS) rather than suspicious for a H\u00fcrthle cell neoplasm (HUR) within the setting of multiple nodules or known LT. The goal of the current study was to address whether this approach is justified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>HC FNA specimens were identified and correlated with ultrasound and surgical pathology reports if available. Multinodularity was determined based on findings on macroscopic examination if imaging results were unavailable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 698 HC FNA specimens were identified, including 576 resected nodules, 455 of which (79%) were benign. The overall risk of malignancy for HUR was 27%, whereas the risk of malignancy for AUS was 10%. The mean size of the benign nodules was 2.1\u00a0cm on surgical resection specimens, with multiple nodules noted in 293 cases (64%) and histologic LT noted in 116 cases (25%). The mean size of the malignant nodules was 2.8\u00a0cm, with multiple nodules and histologic LT noted in 74 cases (61%) and 22 cases (18%), respectively. The malignancy rate did not differ between solitary or multiple nodules (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.52) or in the presence or absence of LT (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.12). However, size did significantly differ between malignant and benign nodules (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The malignancy rate did not differ significantly in the presence of multiple nodules or LT, although the latter demonstrated a statistical trend. A diagnosis of AUS over HUR based solely on the presence of multinodularity is not warranted.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncy.22213","type":"journal-article","created":{"date-parts":[[2019,11,21]],"date-time":"2019-11-21T09:28:58Z","timestamp":1574328538000},"page":"68-75","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Malignancy risk for solitary and multiple nodules in H\u00fcrthle cell\u2013predominant thyroid fine\u2010needle aspirations: A multi\u2010institutional study"],"prefix":"10.1002","volume":"128","author":[{"given":"Kristine S.","family":"Wong","sequence":"first","affiliation":[{"name":"Department of Pathology Brigham and Women's Hospital, Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4808-2714","authenticated-orcid":false,"given":"Vickie Y.","family":"Jo","sequence":"additional","affiliation":[{"name":"Department of Pathology Brigham and Women's Hospital, Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alarice C.","family":"Lowe","sequence":"additional","affiliation":[{"name":"Department of Pathology Brigham and Women's Hospital, Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William C.","family":"Faquin","sequence":"additional","affiliation":[{"name":"Department of Pathology Massachusetts General Hospital Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1318-4238","authenticated-orcid":false,"given":"Andrew A.","family":"Renshaw","sequence":"additional","affiliation":[{"name":"Department of Pathology Miami Baptist Hospital Miami Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akeesha A.","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Virginia Medical Center Charlottesville Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael H.","family":"Roh","sequence":"additional","affiliation":[{"name":"Division of Cytopathology Department of Pathology University of Michigan Ann Arbor Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward B.","family":"Stelow","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Virginia Medical Center Charlottesville Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7768-3901","authenticated-orcid":false,"given":"Jeffrey F.","family":"Krane","sequence":"additional","affiliation":[{"name":"Department of Pathology Brigham and Women's Hospital, Harvard Medical School Boston 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