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Related Experiment Videos

Pathology of the autonomously functioning (hot) thyroid nodule.

H Rubén Harach1, Soledad Solis Sánchez, E Dillwyn Williams

  • 1Services of Pathology and Surgery, "Dr A. Oñativia" Endocrinology and Metabolism Hospital, Salta, Argentina.

Annals of Diagnostic Pathology
|February 14, 2002
PubMed
Summary

Hot nodules, often benign thyroid adenomas, can occasionally be malignant. Some hyperfunctioning thyroid cancers may develop from benign hot nodules, though this progression is rare due to early treatment.

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Area of Science:

  • Endocrinology
  • Pathology
  • Oncology

Background:

  • Hot nodules are hyperfunctioning thyroid nodules identified by scintigraphy.
  • Previous studies have focused on referral populations, potentially skewing observed characteristics.

Purpose of the Study:

  • To describe the pathologic findings of hot nodules.
  • To investigate the potential malignant transformation of hot nodules.
  • To explore the relationship between hot nodules and follicular thyroid neoplasms.

Main Methods:

  • Histopathologic examination of 73 surgically resected hot nodules.
  • Analysis of nodule size, sex ratio, and presence of malignancy.
  • Assessment of cytoarchitectural features and intracolloid oxalate crystals.

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  • Immunohistochemical staining for thyroglobulin.

    • Main Results:

    • Malignancy was found in 8.2% of cases (5 follicular, 1 papillary).
    • Benign tumors included adenomas (71.6%) and less well-differentiated adenomas (28.3%).
    • Intracolloid oxalate crystals were present in 83% of cases, increasing with decreased epithelial activity.
    • Thyroglobulin staining was more pronounced in tumor cells than background thyroid tissue.

    Conclusions:

    • Hot nodules exhibit a diverse morphologic spectrum, including occasional malignancy.
    • A subset of follicular thyroid cancers associated with hyperfunction may arise from benign hot nodules.
    • Progression to malignancy is likely rare due to early detection and treatment of symptomatic hot nodules.