Non-invasive follicular thyroid neoplasm with papillary-like nuclearfeatures (NIFTP): a review and update

Geramizadeh, Bita; Maleki, Zahra

doi:10.1007/s12020-019-01887-z

Cited by 15 publications

(9 citation statements)

References 61 publications

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“…The fourth edition of WHO Classification of Tumours of Endocrine Organs incorporated several borderline/precursor tumors [24]. NIFTP onset brought along a new pitfall, as nuclear features of papillary carcinoma can be present in the entity with an extremely low malignant potential [24,25,26]. In various studies and analyses, the ROM of AUS/FLUS declined when NIFTP was implemented as non-malignancy [27,28].…”

Section: Discussionmentioning

confidence: 99%

Thyroid Bethesda Category AUS/FLUS in Our Microscopes: Three-Year-Experience and Cyto-Histological Correlation

Huhtamella

Kholová

2019

Cancers

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The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) introduced a new category: Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance (AUS/FLUS) comprising of heterogenous lesions with a lesser degree of atypia. Its routine use is a bit controversial. The study cohort included AUS/FLUS thyroid cytopathological diagnoses signed out at Fimlab Laboratories from the period of 1 October 2013 to 31 December 2016. We analyzed all the AUS/FLUS cases, their cytology subclassification, and their cyto-histological correlation, when available. In total, there were 331 AUS/FLUS cases from 252 patients. The mean age was 59.8 years and there were 196 females and 56 males. Repeated AUS/FLUS was diagnosed in 75 (29.8%) cases. Out of 252 patients, 118 (46.8%) were operated on. Sixty-eight were operated on after the first AUS/FLUS diagnosis, 46 after 2 AUS/FLUS diagnoses, and 4 after 3 AUS/FLUS diagnoses. In total, there were 37 (14.7%) malignancies and 40 benign tumors. The risk of malignancy for AUS/FLUS (14.7%) is in agreement with the original TBSRTC risk of malignancy. The risk of neoplasia was 30.6% in our series.

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Section: Discussionmentioning

confidence: 99%

Thyroid Bethesda Category AUS/FLUS in Our Microscopes: Three-Year-Experience and Cyto-Histological Correlation

Huhtamella

Kholová

2019

Cancers

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“…In 2016, the Endocrine Pathology Society working group adopted a new nomenclature for the noninvasive EFVPTC, now known as noninvasive follicular thyroid neoplasm with papillary-like nuclear features or NIFTP [38]. NIFTP has a similar presentation to other thyroid neoplasms and is detected as a palpable nodule or incidentally found during imaging for other reasons [39]. FNA of these lesions is usually reported in categories III-V of the Bethesda system for reporting thyroid cytology [38].…”

Section: Noninvasive Follicular Thyroid Neoplasm With Papillary-like mentioning

confidence: 99%

“…Completion thyroidectomy is not recommended for this type of tumor. NIFTP has an excellent prognosis, with extremely low risk of recurrence, even when treated conservatively with a hemithyroidectomy and no RAI therapy [38][39][40]. Xu et al studied a cohort of large NIFTP, ranging from 4.0-8.0 cm, and showed similar outcomes to smaller lesions with zero risk of recurrence over at least 2 years of follow-up, including in the lesions treated with hemithyroidectomy and no RAI [40].…”

Section: Noninvasive Follicular Thyroid Neoplasm With Papillary-like mentioning

confidence: 99%

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Hemithyroidectomy for Thyroid Cancer: A Review

2020

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Thyroid cancer incidence is on the rise; however, fortunately, the death rate is stable. Most persons with well-differentiated thyroid cancer have a low risk of recurrence at the time of diagnosis and can expect a normal life expectancy. Over the last two decades, guidelines have recommended less aggressive therapy for low-risk cancer and a more personalized approach to treatment of thyroid cancer overall. The American Thyroid Association (ATA) and National Comprehensive Cancer Network (NCCN) thyroid cancer guidelines recommend hemithyroidectomy as an acceptable surgical treatment option for low-risk thyroid cancer. Given this change in treatment paradigms, an increasing number of people are undergoing hemithyroidectomy rather than total or near-total thyroidectomy as their primary surgical treatment of thyroid cancer. The postoperative follow-up of hemithyroidectomy patients differs from those who have undergone total or near-total thyroidectomy, and the long-term monitoring with imaging and biomarkers can also be different. This article reviews indications for hemithyroidectomy, as well as postoperative considerations and management recommendations for those who have undergone hemithyroidectomy.

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“…The extent of surgical procedures can be limited in this case, although surgery is required. NIFTPs usually harbor activating RAS mutation (30–59%), including N-RAS , H-RAS , and, less commonly, K-RAS mutations [19,40,41,42,43,44]. A lack of BRAF V600E mutation, detected by molecular assays or immunohistochemistry, and lack of BRAF V600E -like mutations or other high-risk mutations ( TERT , TP53 ) were included into the 2018 revised diagnostic criteria for NIFTP as secondary criteria [45].…”

Section: Genetic Drivers and Sonographic Pattern Of Different Varimentioning

confidence: 99%

Correlations between Molecular Landscape and Sonographic Image of Different Variants of Papillary Thyroid Carcinoma

Lewiński

Adamczewski

Zygmunt

et al. 2019

JCM

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Papillary thyroid carcinoma (PTC), the most common thyroid cancer, is predominantly driven by mutations in BRAF (primarily p. V600E) and RAS oncogenes. Ultrasound (US) examination provides significant diagnostic data in the management of thyroid nodules, as many sonographic features of thyroid lesions are correlated with the potential risk of thyroid carcinoma. The aim of the study was to analyze the current literature in regard to the potential associations between genetic landscape and sonographic features of PTC. Based on the current literature, sonographic features of PTCs correlate with their molecular drivers, particularly between tumors harboring BRAFV600E versus activating RAS mutations, although many of these findings appear to be dependent on the tumor variant. Suspicious US findings, such as hypoechogenicity, spiculated/microlobulated margins, non-parallel orientation/taller-than-wide shape, and the presence of microcalcifications, are typical for PTC positive for BRAFV600E mutations. On the contrary, tumors with RAS mutations are most frequently hypo- or isoechoic and ovoid-to-round in shape, with smooth margins and without calcifications. There are also some US features typical for PTCs harboring other mutations, including BRAFK601E, RET/PTC rearrangements, PAX8-PPARγ, CTNNB1, and APC. However, further research is necessary, as some rare PTC variants still cannot be reliably analyzed due to the scarce published data.

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Non-invasive follicular thyroid neoplasm with papillary-like nuclearfeatures (NIFTP): a review and update

Cited by 15 publications

References 61 publications

Thyroid Bethesda Category AUS/FLUS in Our Microscopes: Three-Year-Experience and Cyto-Histological Correlation

Thyroid Bethesda Category AUS/FLUS in Our Microscopes: Three-Year-Experience and Cyto-Histological Correlation

Hemithyroidectomy for Thyroid Cancer: A Review

Correlations between Molecular Landscape and Sonographic Image of Different Variants of Papillary Thyroid Carcinoma

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