Thyroid cytology

Top: Hurthle cells in loose, monolayered sheet and singly in FNA of a Hurthle cell lesion (Diff-Quik stain, × 400).

Bottom: A monolayered sheet of benign follicular epithelial cells with honeycomb pattern in FNA of a benign colloid nodule (Diff-Quik stain, × 400).


One of the toughest and most grueling parts of cytology is thyroid cytology. It’s just really, really hard. So many cells, subtleties and slides. This is where I think cytology is crystal ball reading. I’ve (only) seen probably 100 thyroid diff quik slides (the stain seen above) and I cannot reliably tell the difference between Hurthle cells and follicular cells. Hurthle cells are “bubbly” or “poochy” (fat puffy cells). Once my cytology friend called Hurthle cells fatties, then I sort of understood. These two micrographs are taken at the same magnification. 

Ugggghhhhh why so hardddddd

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