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Hyalinizing trabecular tumour of the thyroid: fine-needle aspiration cytological diagnosis and correlation with histology
  1. Chiara Saglietti1,
  2. Simonetta Piana2,
  3. Stefano La Rosa1,
  4. Massimo Bongiovanni1
  1. 1Service of Clinical Pathology, Lausanne University Hospital, Institute of Pathology, Lausanne, Switzerland
  2. 2Pathology Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy
  1. Correspondence to Professor Massimo Bongiovanni, Service of Clinical Pathology, Lausanne University Hospital, Institute of Pathology, 25, rue du Bugnon, Lausanne CH-1011, Switzerland; massimo.bongiovanni{at}chuv.ch

Abstract

Hyalinizing trabecular tumour (HTT) is a rare thyroid neoplasm of follicular cell origin characterised by a trabecular growth pattern and prominent intratrabecular and intertrabecular hyalinisation. These peculiar histological features allow the prompt recognition of this neoplasm in surgical specimens. However, cytological diagnosis of HTT remains elusive and misleading because of overlapping characteristics with other thyroid tumours, particularly papillary thyroid carcinoma (PTC), medullary thyroid carcinoma (MTC) and the newly described non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). Nevertheless, the proper recognition of this neoplasm on preoperative cytological preparations is important to avoid unnecessary overtreatment of this indolent lesion. A thorough review of the literature has revealed that the correct diagnosis of HTT in cytological smears is achieved in only 8% of cases. In a further 6% of cases, diagnostic doubt has been indicated. Sixty percent of published cases of HTT have been misdiagnosed as suggestive, suspicious or positive for PTC. These findings underline the difficulties of a cytological-based diagnosis of such entity. In this article we review the cytomorphological features of HTT and their correlation to histological features to provide the reader with the tools to improve diagnostic performance in the identification of HTT on preoperative cytology.

  • THYROID
  • NEOPLASMS
  • CYTOLOGY
  • IMMUNOCYTOCHEMISTRY

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Footnotes

  • Handling editor Runjan Chetty.

  • Contributors MB: conceived the idea of the project. CS and MB: prepared the manuscript. SLR and SP: revised the manuscript and provided pictures. All authors edited the manuscript before its submission.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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