Hurthle cell adenoma

by Jason Wasserman MD PhD FRCPC
March 26, 2024


A Hurthle cell adenoma is a non-cancerous type of thyroid tumour. It is made up of large pink Hurthle cells that are separated from the normal thyroid tissue by a thin tissue barrier called a tumour capsule. The tumour often forms a lump in the thyroid gland called a nodule.

Hurthle cells

What are the symptoms of a Hurthle cell adenoma?

Most Hurthle cell adenomas present as a painless lump or growth on the front of the neck. For many patients, the tumour is discovered incidentally (by accident), when imaging of the neck is performed for another reason. Large tumours may cause difficulty swallowing or breathing, especially when lying down.

What causes a Hurthle cell adenoma?

Radiation exposure as a child and iodine deficiency are both associated with an increased risk of developing a Hurthle cell adenoma. However, for most patients, the cause remains unknown.

What does it mean if the tumour is described as encapsulated?

Encapsulated means that the tumour is surrounded by a thin layer of tissue called a capsule. The capsule separates the cells in the tumour from the cells in the normal thyroid gland.

tumour capsule

How is this diagnosis made?

To make the diagnosis of a Hurthle cell adenoma, the entire tumour must be removed and sent to a pathologist for examination under a microscope. Your pathologist will then make sure that the tumour cells have not spread past the tumour capsule into the surrounding normal thyroid gland and that no tumour cells are seen in a blood vessel. Because the entire tumour capsule must be examined, the diagnosis cannot be made after only part of the tumour is removed in a procedure called a fine needle aspiration biopsy (FNAB).

What is the difference between Hurthle cell adenoma and Hurthle cell carcinoma?

The cells in a Hurthle cell adenoma and a Hurthle cell carcinoma look very similar when examined under a microscope. However, in contrast to the cells in a Hurthle cell adenoma, the cells in a Hurthle cell carcinoma have broken through the tumour capsule and spread into the surrounding thyroid gland. Pathologists describe this as tumour capsule invasion.

Hurthle cell adenoma

Hurthle cell carcinoma

About this article

This article was written by doctors to help you read and understand your pathology report. Contact us if you have any questions about this article or your pathology report. Read this article for a more general introduction to the parts of a typical pathology report.

Other helpful resources

American Thyroid Association (ATA)
American Cancer Society

Learn more pathology

Atlas of Pathology
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