Noninvasive follicular thyroid neoplasm with papillary-like nuclear features reclassification and its impact on thyroid malignancy rate and treatment

Mao, Melissa; Joyal, Thomas; Picado, Omar; Kerr, Darcy A.; Lew, John I.; Farrá, Josefina C.

doi:10.1016/j.jss.2018.04.013

Cited by 10 publications

(3 citation statements)

References 14 publications

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“…The predictions, which were based on retrospective data from four institutions (three Italian and one American), resulted in a calculated rate of NIFTP of 18.6% among all PTC cases (4). After more than 3 years from the introduction of the new nomenclature, it appears that the initial calculations were overestimated (8,9,10,11,12,13,14,15,16,17,18,19,20,21).…”

Section: Epidemiologymentioning

confidence: 99%

Noninvasive follicular thyroid neoplasm with papillary-like nuclear features: a problematic entity

Zajkowska

Kopczyński

Góźdż

et al. 2020

Endocrine Connections

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Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is a borderline thyroid tumour formerly known as noninvasive encapsulated follicular variant of papillary thyroid carcinoma. The prevalence of NIFTP is estimated at 4.4–9.1% of all papillary thyroid carcinomas worldwide; however, the rate of occurrence of NIFTP is eight times lower in Asian countries than in Western Europe and America. At the molecular level, NIFTP is characterised by the lack of BRAF V600E and BRAF V600E-like mutations or other high-risk mutations (TERT, TP53) and a high rate of RAS mutations, which is similar to other follicular-pattern thyroid tumours. The diagnosis of NIFTP can only be made after histological examination of the entire tumour removed during surgery and is based on strictly defined inclusion and exclusion criteria. Although the diagnosis is postoperative, the combination of certain findings of preoperative tests including ultrasonography, cytology, and molecular testing may raise suspicion of NIFTP. These tumours can be effectively treated by lobectomy, although total thyroidectomy remains an option for some patients. Radioactive iodine and thyroid stimulating hormone suppression therapy are not required. NIFTP has an extremely good prognosis, even when treated conservatively with lobectomy alone. Nevertheless, it cannot be considered as a benign lesion. The risk of adverse outcomes, including lymph node and distant metastases, is low but not negligible.

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Section: Epidemiologymentioning

confidence: 99%

Noninvasive follicular thyroid neoplasm with papillary-like nuclear features: a problematic entity

Zajkowska

Kopczyński

Góźdż

et al. 2020

Endocrine Connections

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“…Systematic review demonstrated significant heterogeneity of cytopathologic findings among the largest observational studies containing ≥14 cases having NIFTP histodiagnosis with cytopathologic correlations. Fifty largest studies included into the systematic analysis (totally 2603 cases with cyto‐histopathological correlations) were reported by Faquin, 5 Mainthia, 6 Zhou, 7 Rosario, 8 Lastra, 9 Çelik, 10 Maletta, 11 Canberk, 12 Lau, 13 Strickland, 14 Howitt, 15 Yang, 16 Song, 17 Kim, 18 Bychkov, 19 Katsakhyan, 20 Brandler, 21 Zhang, 22 Chandler, 23 Zhao, 24 You, 25 Larouche, 26 Hirokawa, 27 Yan, 28 Bizzarro, 29 Glass, 30 Sung, 31 Koshikawa, 32 Legesse, 33 Hahn, 34 Mao, 35 Maleki, 36 Mito, 37 Linhares, 38 Yan, 28 Range and Jiang, 39 Lindeman, 40 Kim, 18 Ibrahim and Wu, 41 Mahajan, 42 Ng, 43 Singh, 44 Selvaggi, 45 Lee, 46 Rana, 47 Li, 48 Kiernan, 49 Ventura, 50 Paulson, 51 and Jaconi et al 52 (Table 4).…”

Section: Resultsmentioning

confidence: 99%

Detailed fine needle aspiration cytopathology findings of noninvasive follicular thyroid neoplasm with papillary‐like nuclear features with nuclear grading correlated to that of biopsy and Bethesda category and systematic review

Kaçar Özkara,

Turan

2023

Diagnostic Cytopathology

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BackgroundNoninvasive follicular thyroid neoplasm with papillary‐like nuclear features (NIFTP) poses diagnostic challenge in fine needle aspiration cytopathology (FNAC). We aimed first to document our FNAC Bethesda categories (BCs) for all of our NIFTPs and compare our findings with those in the literature with series containing at least 14 cases each.MethodsCases with final histopathological diagnoses of NIFTP and their preoperative FNAC were retrieved from 2006 to 2022 and our cytopathological BCs were documented. Then the slides were re‐reviewed in a blinded manner for detailed classification and the results of both the BCs and blinded reclassification were compared with series in the literature for both BCs and detailed cytopathological review of the cases.ResultsThyroid FNACs of 43 out of 86 patients with final NIFTP diagnoses were obtained. Females composed 72.1% (F/M: 31/12); mean age and mean tumor diameter was 47.6 (19–72 years) and 23.4 mm (7–60 mm), respectively. Totally 81.4% (35/43) were classified in the “indeterminate” diagnostic categories; namely 44.2% (19/43) were reported as atypia of undetermined significance (AUS; BC III), 20.9% (9/43) were follicular neoplasm (FN; BC IV), and 16.3% (7/43) were suspicious for malignancy (SM; BC V). No patient was diagnosed as positive for malignancy (BC VI), preoperatively.Detailed cytomorphologic reevaluation revealed heterogeneous cytopathologic findings and nuclear grade (especially nuclear enlargement, membrane irregularity and elongation) significantly increased with respect to BCs. Systematic review confirmed extremely heterogeneous cytomorphologic nature of NIFTP.ConclusionsNIFTPs were categorized most frequently as AUS, followed by FN and SM on FNAC. Our re‐review were not able to specify features solely unique to NIFTP alone but may distinguish these cases from classic papillary thyroid carcinoma.

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“…According to the literature on noninvasive encapsulated FVPTC, cases reclassified into NIFTP were treated by total thyroidectomy often followed by radioactive iodine treatment [ 104 , 105 ]. Current knowledge of the biological potential of NIFTP will allow for a more conservative treatment in the form of a lobectomy [ 104 ]. Furthermore, the Asian approach is far more conservative and even diagnostic lobectomy is thought harmful [ 106 , 107 ].…”

Section: Niftp: Prognosis and Clinical Work-upmentioning

confidence: 99%

Noninvasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features (NIFTP): Tumour Entity with a Short History. A Review on Challenges in Our Microscopes, Molecular and Ultrasonographic Profile

et al. 2022

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Since Noninvasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features (NIFTP) was introduced as a new thyroid tumour entity, many studies, and meta-analyses on diagnosing NIFTP have been published. NIFTP-revised histopathological criteria emerged in 2018. NIFTP is defined as a histological entity and its diagnosis requires a careful histological examination. Its molecular profile is similar to follicular-like tumours. Ultrasound features are unable to differentiate NIFTP. NIFTP is not a cytological diagnosis, but it influences the risk of malignancy in several categories of The Bethesda System for Reporting Thyroid Cytopathology terminology.

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Noninvasive follicular thyroid neoplasm with papillary-like nuclear features reclassification and its impact on thyroid malignancy rate and treatment

Cited by 10 publications

References 14 publications

Noninvasive follicular thyroid neoplasm with papillary-like nuclear features: a problematic entity

Noninvasive follicular thyroid neoplasm with papillary-like nuclear features: a problematic entity

Detailed fine needle aspiration cytopathology findings of noninvasive follicular thyroid neoplasm with papillary‐like nuclear features with nuclear grading correlated to that of biopsy and Bethesda category and systematic review

Noninvasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features (NIFTP): Tumour Entity with a Short History. A Review on Challenges in Our Microscopes, Molecular and Ultrasonographic Profile

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