Outcome and molecular characteristics of non-invasive encapsulated follicular variant of papillary thyroid carcinoma with oncocytic features

Xu, Bin; Reznik, Ed; Tuttle, R. Michael; Knauf, Jeffrey A.; Fagin, James A.; Katabi, Nora; Doğan, Snjezana; Aleynick, Nathaniel; Seshan, Venkatraman; Middha, Sumit; Enepekides, Danny; Casadei, Gian Piero; Solaroli, Erica; Tallini, Giovanni; Ghossein, Ronald; Ganly, Ian

doi:10.1007/s12020-019-01848-6

Cited by 40 publications

(22 citation statements)

References 32 publications

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“…However, they share a similar RAS‐related mutational profile as NIFTP and follicular neoplasm . Follow‐up study showed that these tumors followed a very indolent behavior similar to non‐oncocytic NIFTPs with no distant metastasis, lymph node metastases, or recurrence . As a result, we consider tumors with Hurthle cell features members of the NIFTP category as this approach will help reduce unnecessary overtreatment.…”

Section: Discussionmentioning

confidence: 98%

Cytologic and clinical features of NIFTP: Can we diagnose based on preoperative fine‐needle aspiration

Liang

Sethi

Park

2019

Diagnostic Cytopathology

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Background: Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is considered an indolent neoplasm of the thyroid. Currently, this entity presents a diagnostic challenge on preoperative fine-needle aspiration (FNA) cytology.Methods: Cases of NIFTP and noninvasive encapsulated follicular variant of papillary thyroid carcinoma from January 1994 to August 2018 were retrieved from our institution's pathology databases, and their clinical and cytopathologic features were reviewed.

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Section: Discussionmentioning

confidence: 98%

Cytologic and clinical features of NIFTP: Can we diagnose based on preoperative fine‐needle aspiration

Liang

Sethi

Park

2019

Diagnostic Cytopathology

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“…Although there is no consensus, we believe that tumors composed of cells with oncocytic (Hürthle cells) appearance can be classified as NIFTP if they meet all other diagnostic criteria (Xu et al 2019). We report here the evolution of ten patients with NIFTP with oncocytic features seen at our institution.…”

Section: Diagnosis Of Niftpmentioning

confidence: 97%

Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP): a review for clinicians

Rosário

Mourão

2019

Endocrine-Related Cancer

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Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is an encapsulated or clearly delimited, noninvasive neoplasm with a follicular growth pattern and nuclear features of papillary thyroid carcinoma (PTC). It is considered a ‘pre-malignant’ lesion of the RAS-like group. Ultrasonography (US), cytology and molecular tests are useful to suspect thyroid nodules that correspond to NIFTP but there is wide overlap of the results with the encapsulated follicular variant of PTC (E-FVPTC). In these nodules that possibly or likely correspond to NIFTP, if surgery is indicated, lobectomy is favored over total thyroidectomy. The diagnosis of NIFTP is made after complete resection of the lesion by observing well-defined criteria. In the case of patients who received the diagnosis of FVPTC and whose pathology report does not show findings of malignancy (lymph node metastasis, extrathyroidal invasion, vascular/capsular invasion), if the tumor was encapsulated or well delimited, the slides can be revised by an experienced pathologist to determine whether the diagnostic criteria of NIFTP are met, but special attention must be paid to the adequate representativeness of the capsule and tumor. Since NIFTP is not ‘malignant’, tumor staging is not necessary and patients are not submitted to thyroid cancer protocols or guidelines. We believe that patients with NIFTP without associated malignancy and without nodules detected by US of the remnant lobe (if submitted to lobectomy) can be managed like those with follicular adenoma.

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“…Specifically, RAS mutations were identified in 33% of cases, similar to the 30% in the NIFTP consensus cohort. In addition, mitochondrial DNA mutations were also identified, compatible with an oncocytic phenotype 19. Lymphocytic thyroiditis was also identified in four cases includingtwo NIFTP and two PTC.…”

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confidence: 91%

Hürthle cell lesions on thyroid fine needle aspiration cytology: Molecular and histologic correlation

Schatz-Siemers

Brandler

Oweity

et al. 2019

Diagnostic Cytopathology

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Background Hürthle cell lesions often pose diagnostic challenges, despite their common occurrence on thyroid fine‐needle aspiration cytology (FNAC). The associated molecular alterations are also not well understood. Therefore, our study aimed to delineate the molecular profile of Hürthle cell lesions classified as Bethesda Categories III or IV (atypia of undetermined significance (AUS) or suspicious for follicular neoplasm (SFN)) on FNAC and to correlate this molecular profile with surgical resection findings. Methods This study consisted of 188 Hürthle cell lesions with indeterminate cytology and ThyroSeq® v2/v3 molecular testing results. Surgical follow‐up was available for 33 cases. Results The majority of indeterminate Hürthle cell lesions had negative ThyroSeq® results (61%) and were benign on available surgical follow‐up. The most prevalent mutations involved the RAS gene (21%), which were associated with benign lesions, non‐invasive follicular thyroid neoplasms with papillary‐like nuclear features (NIFTP), and malignancy. The remaining mutations involved less than 18% of the cases, including PAX8/PPARG (3.7%), TSHR (3.7%), EIF1AX (2.7%), MET (2.1%), PTEN (1.6%), clonal copy number alteration (1.6%), TERT (1.1%), and 0.5% each of GNAS, PIK3CA, and TP53 mutations. On follow‐up, 45% were benign, 24% were NIFTP, and 30% were malignant. The malignant cases had different molecular alterations. Conclusion No single molecular alteration defines cytologically indeterminate Hürthle cell lesions; the majority of cases have low‐risk or no molecular alterations and are benign on follow‐up. These findings suggest that molecular testing may be useful, but is not definitive, in determining which cases may be managed conservatively; additional studies are needed to fully determine the negative predictive value in ruling out malignancy.

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Outcome and molecular characteristics of non-invasive encapsulated follicular variant of papillary thyroid carcinoma with oncocytic features

Abstract: Purpose: In 2016, non-invasive encapsulated follicular variant of papillary thyroid carcinoma (NI-EFVPTC) was renamed as noninvasive thyroid follicular neoplasm with papillary-like nuclear features (NIFTP). However, as the study cohort did not mention tumors with oncocytic features,

Cited by 40 publications

References 32 publications

Cytologic and clinical features of NIFTP: Can we diagnose based on preoperative fine‐needle aspiration

Cytologic and clinical features of NIFTP: Can we diagnose based on preoperative fine‐needle aspiration

Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP): a review for clinicians

Hürthle cell lesions on thyroid fine needle aspiration cytology: Molecular and histologic correlation

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