Noninvasive follicular thyroid neoplasm with papillary-like nuclear features: a review for pathologists

Seethala, Raja R.; Baloch, Zubair W.; Barletta, Justine A.; Khanafshar, Elham; Mete, Özgür; Sadow, Peter M.; LiVolsi, Virginia A.; Nikiforov, Yuri E.; Tallini, Giovanni; Thompson, Lester D.�R.

doi:10.1038/modpathol.2017.130

Cited by 112 publications

(102 citation statements)

References 54 publications

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“…In addition, none of our cases of oncocytic FNAC corresponded to an NIFTP. Seethala et al [25] stated that, although some groups have listed oncocytic morphology as an exclusion criterion for NIFTP, their working group is still investigating the possibility of an oncocytic NIFTP.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Diagnosis of Neoplastic or Malignant Hürthle Cell Lesions: A Chimera?

Arco¹,

Fernández-Aceñero²

2018

Acta Cytologica

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Objective: We aimed to review all cytological specimens with Hürthle cells (HC) diagnosed in our institution, identify cytological features related to neoplastic (adenoma or carcinoma) and malignant histology, and discuss the role of clinicopathological findings and clinical management in these cases. Study Design: We included 359 thyroid fine-needle aspiration cytology cases in our study. We reviewed the clinical and cytological features of surgical cases and correlated them with histological diagnosis. We also reviewed the literature on this issue. Results: We found a significant association between neoplasia and highly cellular smears, the absence of colloid, the presence of microfollicles, large-cell dysplasia, prominent nucleoli or macronucleoli, coarse chromatin, nuclear grooves and inclusions, nuclear irregularity, and pleomorphism. The absence of colloid, high cellularity, > 25% of isolated HC, the presence of tridimensional groups, transgressing vessels, nuclear irregularity, prominent nucleoli or macronucleoli, coarse chromatin, hyperchromatism, pleomorphism, and diffuse large-cell dysplasia were features significantly associated with malignancy. Conclusions: No cytological feature alone can predict histological outcome, but all findings related to a neoplastic or malignant histology must be assessed. Individualized management protocols should be developed in each institution.

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Section: Discussionmentioning

confidence: 99%

Preoperative Diagnosis of Neoplastic or Malignant Hürthle Cell Lesions: A Chimera?

Arco¹,

Fernández-Aceñero²

2018

Acta Cytologica

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“…Nuclear grooving was also commonly seen. Frequent intra‐nuclear pseudo‐inclusions (>3) were not identified but occasional pseudo inclusion could be identified in two cases only. Psammoma bodies and papillae were typically absent and there was either no colloid or if present were in the form of thick blotches.…”

Section: Resultsmentioning

confidence: 84%

Noninvasive follicular neoplasm with papillary like nuclear features: A comprehensive analysis with a diagnostic algorithm

Rana

Shreyamsa

Ramakant

et al. 2019

Diagnostic Cytopathology

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Background Noninvasive follicular thyroid neoplasm with papillary‐like nuclear features (NIFTP) lacks the carcinoma label, avoiding aggressive therapy, physiological, social and financial impact of cancer diagnosis. Unfortunately, the preoperative diagnosis is still a challenge. Varied incidence of NIFTP has been document with limited data on preoperative cytological, radiological characteristics and the impact on risk of malignancy in each category of the Bethesda system of reporting thyroid cytopathology. Method Retrospective analysis of 20 NIFTPs with an attempt to provide a preoperative diagnostic algorithm based on the cytological and ultrasound features along with incidence and implication on risk of malignancy in various Bethesda categories with its impact on patient management. Result Incidence of NIFTP in our study was higher in comparison to that documented from other Asian countries. TIRADS 3 was the most common sonographic diagnosis. NIFTP was commonly preceded by indeterminate or benign Bethesda category. Major impact of excluding NIFTP form malignant category was seen on Bethesda categories II and IV with 20% and 27% reduction in risk of malignancy, respectively. Conclusion Retrospective analysis should not be confined only to follicular variant of papillary thyroid carcinoma but cases of follicular adenoma and adenomatous colloid nodule should always be included in review to ascertain the true incidence of NIFTP. NIFTPs are less likely to have malignant preoperative cytology. NIFTP shares major cytological and ultrasound features with follicular adenoma, adenomatous colloid nodule and minimally invasive follicular papillary carcinoma. When analyzed together, taking minor findings in consideration, can favor a diagnosis.

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“…to reclassify noninvasive FVPTC without worrisome histologic features as NIFTP on the basis of the new consensus criteria . Cases showing any well‐formed papilla were excluded for NIFTP . Cases without initial agreement were shown at a multihead microscope to generate a consensus diagnosis.…”

Section: Methodsmentioning

confidence: 99%

“…25 Cases showing any well-formed papilla were excluded for NIFTP. 31 Cases without initial agreement were shown at a multihead microscope to generate a consensus diagnosis. Subcentimeter nodules showing morphologic features consistent with NIFTP were still classified as such despite the size criterion.…”

Section: Reclassification Of Niftpmentioning

confidence: 99%

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The impact of noninvasive follicular thyroid neoplasm with papillary‐like nuclear features on the rate of malignancy for atypia of undetermined significance subcategories

Hang

Westra

Zhou

et al. 2018

Cancer Cytopathology

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Noninvasive follicular thyroid neoplasm with papillary-like nuclear features: a review for pathologists

Cited by 112 publications

References 54 publications

Preoperative Diagnosis of Neoplastic or Malignant Hürthle Cell Lesions: A Chimera?

Preoperative Diagnosis of Neoplastic or Malignant Hürthle Cell Lesions: A Chimera?

Noninvasive follicular neoplasm with papillary like nuclear features: A comprehensive analysis with a diagnostic algorithm

The impact of noninvasive follicular thyroid neoplasm with papillary‐like nuclear features on the rate of malignancy for atypia of undetermined significance subcategories

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