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Distinguishing non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) from classic and invasive follicular-variant papillary thyroid carcinomas based on cytologic features
- Source :
- Journal of the American Society of Cytopathology. 8:11-17
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- Introduction An international panel recently recommended reclassification of non-invasive follicular variant of papillary thyroid carcinoma (PTC) to non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). NIFTPs have little or no risk of recurrence and can be treated with lobectomy alone. Preoperative distinction of NIFTP from PTC will help avoid overtreatment. Materials and Methods All thyroid tumors with a histologic diagnosis of PTC and preceding diagnostic cytology (n = 299) over a 5-year period were identified. Cases meeting criteria for NIFTP were reclassified as such. All NIFTP cases with available cytology (n = 6) and a similar number of randomly selected invasive follicular variant of papillary thyroid carcinoma (IFVPTC; n = 9) and classic PTC (cPTC, n = 11) were evaluated for 18 cytologic features. Results A total of 35 (12%) lesions were reclassified as NIFTP, 194 (65%) were cPTC, and 70 (23%) were IFVPTC. The NIFTPs had a preceding cytologic interpretation of benign (31%), atypia of undetermined significance (34%), follicular neoplasm (9%), suspicious for malignancy (12%), or malignant (14%). Cytologically, NIFTP was distinguished from cPTC by absence of any architectural features in all 6 cases, and by absence of pseudoinclusions ( P P = 0.027) in nearly all. Nuclear pseudoinclusions ( P = 0.001), marginal micronucleoli ( P = 0.018), irregular branching sheets ( P = 0.025), and linear arrangement ( P = 0.025) favored IFVPTC over NIFTP. Conclusions NIFTPs were originally assigned to a variety of cytologic categories. There are several cytologic differences between NIFTP and cPTC or IFVPTC. Our findings support restricting the definitive diagnosis of PTC to cases with architectural features of PTC and/or intranuclear pseudoinclusions.
- Subjects :
- Pathology
medicine.medical_specialty
endocrine system diseases
030209 endocrinology & metabolism
Carcinoma, Papillary, Follicular
medicine.disease_cause
Pathology and Forensic Medicine
Diagnosis, Differential
Thyroid carcinoma
03 medical and health sciences
0302 clinical medicine
Cytology
Adenocarcinoma, Follicular
Follicular phase
Atypia
Humans
Medicine
Thyroid Neoplasms
Thyroid neoplasm
Suspicious for Malignancy
medicine.diagnostic_test
business.industry
Thyroid
medicine.disease
medicine.anatomical_structure
Fine-needle aspiration
Thyroid Cancer, Papillary
030220 oncology & carcinogenesis
business
Subjects
Details
- ISSN :
- 22132945
- Volume :
- 8
- Database :
- OpenAIRE
- Journal :
- Journal of the American Society of Cytopathology
- Accession number :
- edsair.doi.dedup.....5c93f54e1092b5b6fe6d2851eff9b689