Lesions of the thyroid gland composed of Hurthle cells encompass pathologic entities ranging from hyperplastic nodules with Hurthle cell metaplasia to Hurthle cell carcinomas. The cytologic ...distinction between these entities can be diagnostically challenging. Many cytologic features of Hurthle cell lesions that distinguish neoplastic Hurthle cell lesions requiring surgery from those that are benign and nonneoplastic have been described, but with variable usefulness. This is due, in part, to the small numbers of cases examined in previous studies and the limited application of statistical analysis. A morphologic study was made of 139 Hurthle cell lesions of the thyroid gland and statistical analysis applied to identify a set of cytomorphologic features that distinguish benign Hurthle cell lesions (BHCL) from Hurthle cell neoplasms (HCN).
Fine-needle aspiration biopsies (FNABs) of thyroid nodules with a predominant Hurthle cell component and corresponding histologic followup were included in the study. Cases were divided into BHCL and HCN groups on the basis of the histologic diagnosis. All cases were reviewed to assess the following 14 cytologic features: overall cellularity, cytoarchitecture, percentage of Hurthle cells, percentage of single cells, percentage of follicular cells observed as naked Hurthle cell nuclei, background colloid, chronic inflammation, cystic change, transgressing blood vessels (TBV), intracytoplasmic lumina, presence of multinucleated Hurthle cells, nuclear to cytoplasmic ratio, nuclear pleomorphism/atypia, and nucleolar prominence. The results were evaluated by using univariate and stepwise logistic regression (SLR) analysis; statistical significance was achieved at P-values < 0.05.
One hundred thirty-nine FNAB specimens, corresponding to 56 HCN and 83 BHCL, fulfilled the study criteria. Six of the 14 cytologic features evaluated were shown by univariate analysis to be statistically significant in predicting HCN: nonmacrofollicular architecture (P < 0.001), absence of background colloid (P < 0.001), absence of chronic inflammation (P < 0.001), presence of TBV (P < 0.001), > 90% Hurthle cells (P < 0.001), and >10% single Hurthle cells (P = 0.014). The first four of these features were also shown to be statistically significant in the SLR analysis (P = 0.005, 0.010, 0.016, and 0.045, respectively), and when all four of these features were present HCN was correctly identified 86% of the time.
In the current study of 139 FNAB specimens of thyroid Hurthle cell nodules, 14 cytologic features were examined and 6 were found to be statistically significant in identifying HCN. The following four features, when found in combination, were found to be highly predictive of HCN: nonmacrofollicular architecture, absence of colloid, absence of inflammation, and presence of TBV.
We report the detection of pulsed gamma-rays from the young, spin-powered radio pulsar PSR J2021+3651 using data acquired with the Large Area Telescope (LAT) on the Fermi Gamma-ray Space Telescope ...(formerly GLAST). The light curve consists of two narrow peaks of similar amplitude separated by 0.468 {+-} 0.002 in phase. The first peak lags the maximum of the 2 GHz radio pulse by 0.162 {+-} 0.004 {+-} 0.01 in phase. The integral gamma-ray photon flux above 100 MeV is (56 {+-} 3 {+-} 11) x 10{sup -8} cm{sup -2} s{sup -1}. The photon spectrum is well-described by an exponentially cut-off power law of the form dF/dE = kE{sup -{Gamma}}e{sup (-E/E{sub c})} where the energy E is expressed in GeV. The photon index is {Gamma} = 1.5 {+-} 0.1 {+-} 0.1 and the exponential cut-off is E{sub c} = 2.4 {+-} 0.3 {+-} 0.5 GeV. The first uncertainty is statistical and the second is systematic. The integral photon flux of the bridge is approximately 10% of the pulsed emission, and the upper limit on off-pulse gamma-ray emission from a putative pulsar wind nebula is < 10% of the pulsed emission at the 95% confidence level. Radio polarization measurements yield a rotation measure of RM = 524 {+-} 4 rad m{sup -2} but a poorly constrained magnetic geometry. Re-analysis of Chandra data enhanced the significance of the weak X-ray pulsations, and the first peak is roughly phase-aligned with the first gamma-ray peak. We discuss the emission region and beaming geometry based on the shape and spectrum of the gamma-ray light curve combined with radio and X-ray measurements, and the implications for the pulsar distance. Gamma-ray emission from the polar cap region seems unlikely for this pulsar.
We report the discovery of gamma-ray pulsations from the nearby isolated millisecond pulsar PSR J0030+0451 with the Large Area Telescope (LAT) on the Fermi Gamma-ray Space Telescope (formerly GLAST). ...This discovery makes PSR J0030+0451 the second millisecond pulsar to be detected in gamma-rays after PSR J0218+4232, observed by the EGRET instrument on the Compton Gamma Ray Observatory. The spin-down power {dot E} = 3.5 x 10{sup 33} ergs s{sup -1} is an order of magnitude lower than the empirical lower bound of previously known gamma-ray pulsars. The emission profile is characterized by two narrow peaks, respectively 0.07 {+-} 0.01 and 0.08 {+-} 0.02 wide, separated by 0.44 {+-} 0.02 in phase. The first gamma-ray peak falls 0.15 {+-} 0.01 after the main radio peak. The pulse shape is similar to that of the 'normal' gamma-ray pulsars. An exponentially cut-off power-law fit of the emission spectrum leads to an integral photon flux above 100 MeV of (6.76 {+-} 1.05 {+-} 1.35) x 10{sup -8} cm{sup -2} s{sup -1} with cut-off energy (1.7 {+-} 0.4 {+-} 0.5) GeV. Based on its parallax distance of (300 {+-} 90) pc, we obtain a gamma-ray efficiency L{sub {gamma}}/{dot E} {approx_equal} 15% for the conversion of spin-down energy rate into gamma-ray radiation, assuming isotropic emission.
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