Reply to Fine-Needle Cytology of Hurthle Cell Tumors and Morphometry

摘要

I would like to thank Drs. Zeppa and Vitale for their interest in my article. According to the study by Zeppa et al, in which they performed morphometry of 40 histo-logically proven Hurthle cell lesions, there was a statistically significant difference in the mean nuclear area of Hurthle cell carcinomas and adenomas, with the smallest mean nuclear area and the lowest standard deviation being found in the Hiirthle cell carcinomas. However, not all morphometric studies have shown similar results. For example, Pambuccian et al, who also performed computerized morphometry in fine-needle aspiration samples of Hiirthle cell tumors to measure features such as the areas, perimeters, and shape factors of individual cells, nuclei and nucleoli, nucleocytoplasmic and nuclear-cytoplasmic ratios, did not find statistically significant differences in the nuclear area and its standard deviation between the benign and malignant Hiirthle cell tumors. They found, however, that the nucleolar features were the ones demonstrating statistically significant differences between Hiirthle cell adenomas and Hiirthle cell carcinomas, but that even the most effective morphometric parameter (ie, the nucleolar form factor) did not achieve perfect discrimination for individual cases. And therein lay the limitations with morphometric studies: although statistically significant parameters can be identified for the overall group of benign versus malignant tumors, they are imperfect when applied to individual cases because the overlap is too large to allow practical application.