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Updated: May 25, 2026
Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration
Published on: November 10, 2014
Hürthle cell metaplasia on fine-needle aspiration biopsy is not by itself an indication for thyroid surgery
Kevin Hudak1, Haggi Mazeh, Rebecca S Sippel
1Section of Endocrine Surgery, Department of Surgery, University of Wisconsin, Madison, WI 53792, USA.
Introduction:
The aim of this study was to assess the malignancy rate in patients with Hürthle cell metaplasia (HCM) on fine-needle aspiration biopsy (FNAB).
Methods:
The pathology results of patients with benign colloid (BC) and HCM on FNAB were compared using a prospective database.
Results:
One hundred fifty-three (65%) patients had BC on FNAB, and 82 (35%) had HCM. The mean nodule size was similar in both groups (25 ± 2 mm vs 26 mm ± 2 mm, P = .83). Malignancy was identified on the final pathology report in 21 (14%) versus 13 (16%) patients in the BC and HCM groups, respectively (P = .66). Of the patients with malignancy, the tumor was determined as microcarcinoma in 76% in the BC groups versus 85% in the HCM group (P = .48) and as incidental in 71% versus 85% (P = .39).
Conclusions:
A result of HCM on FNAB carries a similar rate of malignancy as BC and should not be treated differently. Most of the malignancies found were incidental microcarcinomas.
