Format

Send to

Choose Destination
Cytopathology. 2017 Dec;28(6):495-502. doi: 10.1111/cyt.12459. Epub 2017 Sep 3.

The impact of the non-invasive follicular thyroid neoplasm with papillary-like nuclear feature terminology in the routine diagnosis of thyroid tumours.

Author information

1
Department of Medicine and Surgery, Section of Pathology, University Milan Bicocca, Monza, Italy.
2
Department of Endocrinology, San Gerardo Hospital, Monza, Italy.
3
Department of Surgery, San Gerardo Hospital, Monza, Italy.
4
Department of Surgical Pathology, Centro Diagnostico Italiano, Milan, Italy.

Abstract

BACKGROUND:

Due to the recent proposal of the non-invasive follicular thyroid neoplasm with papillary-like nuclear feature (NIFTP) category, the authors analyse the state of the art in the challenging diagnosis of follicular thyroid neoplasms in routine practice.

METHODS AND RESULTS:

A consecutive series of 200 histological diagnoses, with complete cytological correlation, was analysed following the introduction of the NIFTP definition. The study was conducted in a general hospital with a high prevalence of thyroid benign nodules that accounted for approximately 60% of surgically-treated nodules. The significant incidence of the new NIFTP category was 7%. Concurrently, a gradual decrease of the follicular variant of papillary thyroid carcinoma (fvPTC) was observed (3.5%). When evaluating the FNA biopsies within the NIFTP group, despite the systematic evaluation of nuclear crowding, enlargement, irregularities and clearing, the final cytological class was often indeterminate for malignancy (Thy3/III-IV, 71%). At histology, the application of the semiquantitative NIFTP score for the evaluation of the PTC-like nuclear features was able to discriminate benign lesions (score 0/1) from fvPTC (score 2/3). A certain degree of overlapping still persisted between NIFTP and fvPTC (score 2) or between NIFTP and benign lesions (score 1).

CONCLUSIONS:

In the routine evaluation of FNA biopsies, the presence of subtle and questionable PTC-like nuclear features still remains a controversial aspect of the diagnostic workflow. Given that the NIFTP category was introduced to stratify the low-risk group of thyroid tumours more precisely, pathologists should force themselves to apply the nuclear score rigorously and to classify cases assigned a score of 1 as benign proliferations.

KEYWORDS:

follicular variant papillary thyroid carcinoma; noninvasive follicular thyroid neoplasm with papillary-like nuclear feature ; thyroid carcinoma

PMID:
28868665
DOI:
10.1111/cyt.12459
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center