Comprising roughly 4% of all thyroid cancers, Hürthle cell follicular carcinoma (HCFC) is a well-differentiated malignant tumor of the thyroid gland composed of mitochondrialrich oncocytes. Although most authors continue to consider it a variant of follicular cell carcinoma, HCFC has somewhat more aggressive behavior with an increased incidence of invasion and a higher predilection for lymphatic invasion . Cytologic evaluation shows an abundance of oncocytic cells characterized by abundant polygonal cytoplasm, distinct cell borders, large nucleoli and large nuclei with occasional pleomorphism and atypia . Hürthle cell neoplasms are typically well-encapsulated and considered malignant only when capsular invasion or lymphovascular invasion is noted  .
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