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My approach to oncocytic tumours of the thyroid

Department of Pathology, University Health Network and Toronto Medical Laboratories and Department of Laboratory Medicine and Pathobiology, University of Toronto, The Freeman Centre for Endocrine Oncology and The Ontario Cancer Institute, 610 University Avenue, Toronto, Ontario, Canada M5G 2M9

Correspondence to:
Dr S L Asa
610 University Avenue, Suite 4-302, Toronto, Ontario M5G 2M9, Canada; sylvia.asa{at}uhn.on.ca
ABSTRACT
The traditional approach to oncocytic thyroid lesions classified these as a separate entity, and applied criteria that are somewhat similar to those used for follicular lesions of the thyroid. In general, the guidelines to distinguish hyperplasia from neoplasia, and benign from malignant were crude and unsubstantiated by scientific evidence. In fact, there is no basis to separate oncocytic lesions from other classifications of thyroid pathology. The factors that result in mitochondrial accumulation are largely unrelated to the genetic events that result in proliferation and neoplastic transformation of thyroid follicular epithelial cells. The concept of classifying oncocytic lesions, including follicular variant papillary carcinomas, based on nuclear morphology, immunohistochemical profiles, and molecular markers may pave the way for a better understanding of the biology of oncocytic lesions of the thyroid.

Keywords: immunohistochemistry; molecular diagnostics; oncocytes; thyroid; tumours

Abbreviations: CK, cytokeratin; PTH, parathyroid hormone; RT-PCR, reverse transcription polymerase chain reaction; TTF-1 thyroid transcription factor 1

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