Cytopathology of <scp>non‐invasive follicular thyroid neoplasm with papillary‐like nuclear features:</scp> A comparative study with similar patterned <scp>papillary thyroid carcinoma</scp> variants

Mahajan, Shalvi; Agarwal, Shipra; Kocheri, N.; Jain, Deepali; Mathur, Sandeep; Iyer, V. K.

doi:10.1111/cyt.12537

Cited by 26 publications

(38 citation statements)

References 33 publications

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“…However, ultrasonogrophic, cytomorphologic, and molecular features have some overlap between EFVPTC and IFVPTC, making it difficult to distinguish between them clearly. Furthermore, it is difficult to distinguish IFVPTC from FN since significant number of IFVPTCs are classified as Bethesda category III (atypia of undetermined significance/follicular lesion of undetermined significance), or IV (follicular neoplasm/suspicious for follicular neoplasm) in fine needle aspiration (FNA) cytology . To assist with preoperative decision making, we attempted to focus on distinguishing IFVPTCs from follicular‐patterned neoplasms, including EFVPTC and FN based on immunohistochemistry expression.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of HBME‐1, CK19, Galectin 3, and CD56 in the subtypes of follicular variant of papillary thyroid carcinoma

Cho

Kim

2018

Pathology International

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Our aim is to explore differences in Hector Battifora mesothelial‐1 (HBME‐1), cytokeratin‐19 (CK19), Galectin‐3 (Gal‐3), and CD56 expression in infiltrative follicular variants of papillary carcinoma (IFVPTC) and encapsulated follicular variants of papillary carcinoma (EFVPTC) and to provide clues for distinguishing the two subtypes preoperatively. Tissue microarrays from 100 EFVPTC (45 non‐invasive follicular thyroid neoplasms with papillary‐like nuclear features (NIFTP) and 55 invasive EFVPTCs), 43 IFVPTCs, and 64 follicular neoplasms (FN) were immunostained with HBME‐1, CK19, Gal‐3, and CD56. Each case was scored 1 point for every positive result. Immunohistochemical expression was not significantly different in invasive EFVPTC and NIFTP, except for that of HBME‐1. HBME‐1, CK19, Gal‐3, and CD56 expression were significantly higher in IFVPTC than in EFVPTC. At the cutoff of 3 points, the score method had special diagnostic value for differentiating IFVPTC from EFVPTC and FN and for predicting lymph node metastasis. Scoring of immunohistochemistry results may be applied to core biopsy or cell blocks to assist ultrasonographic, cytologic and molecular tests in differentiating IFVPTC and EFVPTC preoperatively, possibly appropriately guiding EFVPTC preoperatively for limited operation or active surveillance.

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Section: Discussionmentioning

confidence: 99%

Diagnostic value of HBME‐1, CK19, Galectin 3, and CD56 in the subtypes of follicular variant of papillary thyroid carcinoma

Cho

Kim

2018

Pathology International

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“…In spite of Asian continent being a major contributor to worldwide prevalence of thyroid cancer (according to GLOBOCON database; estimated 48% new cases in 2012), the prevalence of NIFTP in Asians has not been reported extensively as compared with the western world . There are limited studies from Asia and even fewer form India and those present have reported a significantly lower prevalence (0%‐5%) as compared to western data (15%‐25%) …”

Section: Introductionmentioning

confidence: 77%

Noninvasive follicular neoplasm with papillary like nuclear features: A comprehensive analysis with a diagnostic algorithm

Rana

Shreyamsa

Ramakant

et al. 2019

Diagnostic Cytopathology

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Background Noninvasive follicular thyroid neoplasm with papillary‐like nuclear features (NIFTP) lacks the carcinoma label, avoiding aggressive therapy, physiological, social and financial impact of cancer diagnosis. Unfortunately, the preoperative diagnosis is still a challenge. Varied incidence of NIFTP has been document with limited data on preoperative cytological, radiological characteristics and the impact on risk of malignancy in each category of the Bethesda system of reporting thyroid cytopathology. Method Retrospective analysis of 20 NIFTPs with an attempt to provide a preoperative diagnostic algorithm based on the cytological and ultrasound features along with incidence and implication on risk of malignancy in various Bethesda categories with its impact on patient management. Result Incidence of NIFTP in our study was higher in comparison to that documented from other Asian countries. TIRADS 3 was the most common sonographic diagnosis. NIFTP was commonly preceded by indeterminate or benign Bethesda category. Major impact of excluding NIFTP form malignant category was seen on Bethesda categories II and IV with 20% and 27% reduction in risk of malignancy, respectively. Conclusion Retrospective analysis should not be confined only to follicular variant of papillary thyroid carcinoma but cases of follicular adenoma and adenomatous colloid nodule should always be included in review to ascertain the true incidence of NIFTP. NIFTPs are less likely to have malignant preoperative cytology. NIFTP shares major cytological and ultrasound features with follicular adenoma, adenomatous colloid nodule and minimally invasive follicular papillary carcinoma. When analyzed together, taking minor findings in consideration, can favor a diagnosis.

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“…Twenty-nine cases of NIFTP/FVPTC assessed in a previous study [15] could be retrieved. Of the 8 cases of PTC-FP included in that study, 6 cases were available for re-evaluation.…”

Section: Resultsmentioning

confidence: 99%

“…For this, all PDTC cases diagnosed over the same period with available FNA smears were included. The cytological features of NIFTP/FVPTC and PTC-FP cases have been recently published in a study from the same institute [15]. These cases were re-evaluated from the perspective of the current study.…”

Section: Methodsmentioning

confidence: 99%

“…χ 2 test and Fisher exact test were used to check the statistical significance of the data. For statistical analysis, cases of NIFTP and FVPTC were combined into a single group, keeping in mind common cytological and histological features shared by them [15]. The parameters having p values ≤0.05 were further compared between the SVPTC group and the other groups individually.…”

Section: Methodsmentioning

confidence: 99%

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Cytopathology of Solid Variant of Papillary Thyroid Carcinoma: Differential Diagnoses with other Thyroid Tumors

et al. 2018

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Objectives: Solid variant of papillary thyroid carcinoma (SVPTC) is rare, differing from classical PTC (cPTC) in architecture and outcome. We evaluated the cytomorphology of SVPTC cases to assess the feasibility of a preoperative diagnosis. Study Design: SVPTC cases were evaluated for architecture, nuclear features, and Bethesda category and were compared with noninvasive follicular thyroid neoplasm with papillary-like nuclear features/follicular variant of PTC (NIFTP/FVPTC), cPTC, and poorly differentiated thyroid carcinoma (PDTC). Results: Nine SVPTCs, 29 NIFTP/FVPTCs, 12 cPTCs, and 4 PDTCs were included. The predominant architecture in most SVPTCs was solid fragment, which is helpful in differentiating them from NIFTP/FVPTC (p < 0.001) and cPTC (p = 0.006) but not from PDTC. The presence of microfollicles led to misinterpretation as NIFTP/FVPTC/follicular neoplasm in 4 patients. All but 1 SVPTC showed diffuse nuclear features. Intranuclear pseudoinclusions (INIs) were seen in 67% of SVPTCs as compared to 83% of cPTCs, 14% of NIFTP/FVPTCs (p = 0.005), and none of PDTCs. SVPTC cases were commonly (78%) categorized as intermediate/suspicious. Conclusions: The presence of solid fragments and lack of true papillae are helpful in differentiating SVPTC from cPTC. Solid fragments, trabeculae, the extent of nuclear features, and INIs should be looked for in cases with prominent microfollicles for distinguishing SVPTC from NIFTP/FVPTC. None of the features were helpful in differentiating SVPTC from PDTC.

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Cytopathology of non‐invasive follicular thyroid neoplasm with papillary‐like nuclear features: A comparative study with similar patterned papillary thyroid carcinoma variants

Abstract: NIFTP and FVPTC show a similar distribution among the Bethesda categories hence precluding conclusive distinction on cytology. PTC-FP, in contrast, was found to have a statistically significant higher nuclear score and more commonly showed malignant cytology.

Cited by 26 publications

References 33 publications

Diagnostic value of HBME‐1, CK19, Galectin 3, and CD56 in the subtypes of follicular variant of papillary thyroid carcinoma

Diagnostic value of HBME‐1, CK19, Galectin 3, and CD56 in the subtypes of follicular variant of papillary thyroid carcinoma

Noninvasive follicular neoplasm with papillary like nuclear features: A comprehensive analysis with a diagnostic algorithm

Cytopathology of Solid Variant of Papillary Thyroid Carcinoma: Differential Diagnoses with other Thyroid Tumors

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