I agree with most of the people here. The neck FNA is this recurrent thyroid carcinoma, which shows Hurthle cell features. Immunostains were performed to rule out medullary carcinoma. The outside diagnosis for this case is "papillary carcinoma, Hurthle cell varaint", we feel that the nuclear features are focal and not enough for papillary carcinoma, so we called this Hurthle cell carcinoma.

 The differential diagnosis for thyroid neoplasm with Hurthle cell features should always include Hurthle cell neoplasm, Hurthle cell variant of papillary carcinoma, medullary carcinoma, and metastatic malignancies, such as renal cell carcinoma. Hope this case illustrates that.

 译文如下：I agree with most of the people here. 同意多数人的意见，The neck FNA is this recurrent thyroid carcinoma, which shows Hurthle cell features. 该例为甲状腺癌复发病例，有Hurthle 细胞特点， Immunostains were performed to rule out medullary carcinoma. 免疫组化排除了髓样癌，The outside diagnosis for this case is "papillary carcinoma, Hurthle cell varaint", 他在外院被诊断为乳头状癌Hurthle 细胞变异型，we feel that the nuclear features are focal and not enough for papillary carcinoma, so we called this Hurthle cell carcinoma.我们感觉该例的乳头状癌的细胞核特点不足以诊断乳头状癌，最后我们发的报告是Hurthle 细胞癌 。The differential diagnosis for thyroid neoplasm with Hurthle cell features should always include Hurthle cell neoplasm, Hurthle cell variant of papillary carcinoma, medullary carcinoma, and metastatic malignancies, such as renal cell carcinoma. 有Hurthle 细胞特点的甲状腺肿瘤鉴别应该包括Hurthle 细胞癌，Hurthle 细胞变异的乳头状癌，髓样癌，转移性癌如转移性肾细胞癌。Hope this case illustrates that.希望本例对大家有帮助。

 谢谢陈博士！

 每次陈博士发的病例帖子都能让人眼睛一亮、视野开阔和增长见识，非常感谢！期待陈博士发出更多的好帖子供我们大家学习。