Reply to Young Investigator Challenge: Molecular testing in noninvasive follicular thyroid neoplasm with papillary‐like nuclear features

Jiang, Xiaoyin “Sara”; Harrison, Grant; Datto, Michael B.

doi:10.1002/cncy.21829

Cited by 5 publications

(3 citation statements)

References 2 publications

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“…This genetic pro le is similar to the one found in other follicular lesions (such as PVCPT, follicular adenoma and follicular carcinoma), and differs from the usual molecular ndings in classic PTC, further warranting the reclassi cation of NIFTP as a different entity. In our series, HRAS and NRAS mutations were equally frequent (6.5% each), in contrast with other reports, in which HRAS mutations comprise between 25-50% of cases [1,[27][28][29][30][31][32][33][34] being NRAS mutations the most usual [27,28,35,36].…”

Section: Resultscontrasting

confidence: 90%

Non-invasive follicular neoplasm with papillary-like nuclear features: a challenging and infrequent entity in Argentina

Saban

Tolaba²,

Orlandi³

et al. 2022

Endocrine

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Purpose: Non-invasive encapsulated follicular variant of papillary thyroid cancer was reclassi ed as noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). These neoplasms have an extremely low malignant potential. The aim of this study was 1) to assess the prevalence of NIFTP in patients with papillary thyroid carcinoma, 2) to evaluate their outcomes and 3) to determine their molecular pro le. Methods: Multicenter, descriptive, retrospective study. Patients with papillary thyroid cancer diagnosed from January 2006 to December 2016 from 11 referral centers were included. Diagnosis of NIFTP was based on criteria described by Nikiforov et al. in 2018. At least two pathologists agreed on the diagnosis. Two thousand six hundred and seventy-seven papillary thyroid cancer patients were included; 456 (17%) of them were follicular variant papillary thyroid cancer, and 30 (1.12%) ful lled diagnostic criteria for NIFTP.Results: Each of the 30 included patients underwent a total thyroidectomy, and 50% were treated with radioiodine (median dose 100 mCi). After a median follow up of 37 months, 84% of patients had an excellent response, 3% had an indeterminate response and data was missing in the remaining 13%. No metastatic lymph nodes, distant metastases or recurrences were found. RAS mutations were detected in 4 patients (13%). Conclusion:The prevalence of NIFTP in our series is amongst the lowest reported. Excellent outcomes of patients underscore their low malignant potential. Molecular ndings differ from other series, probably related to environmental or ethnic features of our population and the meticulous criteria for diagnosing NIFTP.

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Section: Resultscontrasting

confidence: 90%

Non-invasive follicular neoplasm with papillary-like nuclear features: a challenging and infrequent entity in Argentina

Saban

Tolaba²,

Orlandi³

et al. 2022

Endocrine

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“…The authors of the study submitted 50 blocks of tumour to evaluate for high‐grade features, with none identified. The very thorough histological evaluation of the tumour, along with photographs and additional description provided of this tumour, indicates that the tumour probably met histological criteria for NIFTP. Because of the lack of follow‐up data for tumours that appear histologically like NIFTP with a TERT mutation, the biological behaviour of such tumours is not established.…”

Section: Molecular Characteristics Of Niftp and Implications For Molementioning

confidence: 95%

A user's guide to non‐invasive follicular thyroid neoplasm with papillary‐like nuclear features (NIFTP)

Hung

Barletta

2017

Histopathology

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The term non‐invasive follicular thyroid neoplasm with papillary‐like nuclear features (NIFTP) was recently introduced to replace a subset of follicular variant of papillary thyroid carcinoma (FVPTC). The goal of this change was to promote more conservative management of these tumours and spare patients the psychological burden of a cancer diagnosis. The histological diagnosis of NIFTP is stringent: the tumour needs to demonstrate encapsulation or circumscription, a purely follicular architecture and the presence of nuclear features of papillary thyroid carcinoma, while lacking capsular and vascular invasion, a significant component of solid growth and high‐grade features (increased mitotic activity and necrosis). In order to ensure that these inclusion and exclusion criteria are met, the tumour must be sampled extensively, with the entire capsule/periphery submitted in all cases. When sampled by fine‐needle aspiration, NIFTP is usually classified within the indeterminate categories of the Bethesda System for Reporting Thyroid Cytopathology. NIFTP is characterized genetically by frequent RAS mutations, although rarely other alterations, such as the BRAF K601E mutation and gene rearrangements in PPARG or THADA, may occur. In this review, we will examine the history of FVPTC and the findings and factors that culminated in the introduction of the NIFTP terminology. A discussion will follow with the histological, cytological and molecular characteristics of NIFTP. We will conclude by considering the potential impact of the introduction of the NIFTP terminology.

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“…43,44 Another case with lymphnode metastasis was reported in a cytologic study of NIFTP, but without adequate histologic documentation. 45,46 Cho et al 24 identify a 3% nodal metastatic rate in NIFTP even when papillae are entirely excluded, however, despite the extensive examination by the authors, it is plausible that an undetected microcarcinoma is responsible for this nodal disease rather than the NIFTP itself. None of the other well-documented cases of NIFTP metastasized or recurred, even when the only treatment was lobectomy.…”

Section: Clinical Behavior: the Implications Of A Niftp Diagnosismentioning

confidence: 98%

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

et al. 2018

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The rising incidence of papillary thyroid carcinoma is linked in part to inclusion of noninvasive follicular variant of papillary thyroid carcinoma. Despite its designation as carcinoma, noninvasive follicular variant of papillary thyroid carcinoma appears to be exceptionally indolent, often over treated by current treatment practices. Additionally, criteria for diagnosis have historically been subjective and challenging. Recently, an international multidisciplinary collaborative group performed a clinicopathologic survey of such cases with extended follow-up and concluded based on the outcome data that a revision in nomenclature was warranted, proposing 'Noninvasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features (NIFTP).' This monograph is a synopsis and guide for pathologists on NIFTP and focuses on histologic features, including inclusion and exclusion criteria used to define NIFTP, as well as grossing guidelines, reporting practices, and potential diagnostic limitations.

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Reply to Young Investigator Challenge: Molecular testing in noninvasive follicular thyroid neoplasm with papillary‐like nuclear features

Cited by 5 publications

References 2 publications

Non-invasive follicular neoplasm with papillary-like nuclear features: a challenging and infrequent entity in Argentina

Non-invasive follicular neoplasm with papillary-like nuclear features: a challenging and infrequent entity in Argentina

A user's guide to non‐invasive follicular thyroid neoplasm with papillary‐like nuclear features (NIFTP)

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

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