Patients with Non-invasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features are Unlikely to have Malignant Preoperative Cytology

Singh, Richa; Ávila, Jorge Pérez; Jo, Kahee; Nguyen, Kevin Tri; Carrillo, Nika Roa; Huang, Eric C.; Campbell, Michael J.

doi:10.1245/s10434-017-6038-5

Cited by 21 publications

(19 citation statements)

References 19 publications

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“…In contrast to the microfollicular architecture of NIFTP, cPTC cells are distributed chiefly in sheets and papillae, and show prominent nuclear features including grooves and more frequent and easily identifiable INI, and psammomatous calcification . cPTC is more likely to be categorised into the highest TBSRTC categories (SFM and malignant) as compared to NIFTP, which usually falls into one of the intermediate categories (AUS/FLUS, FN/SFN, SFM; Table ) . We compared NIFTP cytology with that of cPTC showing a predominant follicular pattern (PTC‐FP).…”

Section: Discussionmentioning

confidence: 99%

“…Although cytology of NIFTP has been variably compared with cPTC (Table ), we did not find any publication analogising cytopathological features of NIFTP and PTC‐FP. Singh et al, however, compared cytological distribution of NIFTP, FVPTC, cPTC and other PTC variants into the various Bethesda categories . While the authors did not specify the various subtypes included under other PTC variants, they found NIFTP patients (14%) to be least likely to have malignant cytology ( P < .001) as compared to the various PTCs studied (80%) .…”

Section: Discussionmentioning

confidence: 99%

“…Singh et al, however, compared cytological distribution of NIFTP, FVPTC, cPTC and other PTC variants into the various Bethesda categories . While the authors did not specify the various subtypes included under other PTC variants, they found NIFTP patients (14%) to be least likely to have malignant cytology ( P < .001) as compared to the various PTCs studied (80%) . They even reported statistically significant association between malignant cytology and a decreased risk of a final diagnosis of NIFTP ( P < .001) …”

Section: Discussionmentioning

confidence: 99%

“…A greater challenge being evaluated by cytopathologists is differentiation of NIFTP from FVPTC. Studies comparing cytology features of NIFTP with FVPTC have not been conclusive (Table ) …”

Section: Discussionmentioning

confidence: 99%

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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

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…A greater challenge being evaluated by cytopathologists is differentiation of NIFTP from FVPTC. Studies comparing cytology features of NIFTP with FVPTC have not been conclusive (Table ) …”

Section: Discussionmentioning

confidence: 99%

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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

et al. 2018

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“…The extent of all the changes related to the NIFTP reclassification apparently depends on the incidence of NIFTP in a certain population. Approximately, 30 studies have been conducted in America, Europe and Asia reporting variable incidence . Bychkov et al, in a meta‐analysis, documented an average worldwide prevalence rate of 9.1%, with a lower rate in Asian studies (1.6%) as compared with non‐Asian countries (13.3%) .…”

Section: Discussionmentioning

confidence: 99%

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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Papillae, psammoma bodies, and/or many nuclear pseudoinclusions are helpful criteria but should not be required for a definitive cytologic diagnosis of papillary thyroid carcinoma: An institutional experience of 207 cases with surgical follow up

Elsheikh,

Thomas,

Brainard

et al. 2024

Cancer Cytopathology

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BackgroundNoninvasive follicular thyroid neoplasm with papillary‐like features (NIFTP) was introduced in 2016 replacing noninvasive follicular variant of papillary thyroid carcinoma, with recommendations to label them “noncancer.” To avoid reducing risk of malignancy (ROM) and overdiagnosing NIFTP as malignant, some authors required restricted cytologic criteria (RC) for a definitive diagnosis of papillary thyroid carcinoma (PTC), including papillae, psammoma bodies. or ≥3 nuclear pseudoinclusions. Since then, NIFTP criteria have been revised, biologic behavior better understood, and incidence reported to be much lower than initially anticipated. This study examines the impact of RC on PTC cytologic diagnoses, ROM, and detection of clinically significant carcinomas (CSC).Materials and MethodsA total of 207 thyroid FNAs originally diagnosed as PTC and suspicious for PTC (SPTC) with surgical follow‐up were evaluated. RC were retrospectively applied to cases as a requirement for diagnosing PTC, and cases that did not meet RC were reclassified as SPTC. ROMs and diagnostic accuracies of pre‐ and post‐RC diagnoses were correlated with followup CSC.ResultsRC were met in 118/142 (83%) and 20/65 (31%) of cases originally diagnosed as PTC and SPTC, respectively. Post‐RC, 29% (19/65) of CSC originally diagnosed as SPTC were upgraded to PTC, and 17% (24/142) of CSC originally diagnosed as PTC were downgraded to SPTC. No NIFTPs were diagnosed as malignant.ConclusionsRC should not be required for a definitive diagnosis of PTC when other nuclear features of PTC are diffuse and overt. Applying RC, however, helps the pathologist arrive at a more definitive diagnosis of PTC in suspicious cases.

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Patients with Non-invasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features are Unlikely to have Malignant Preoperative Cytology

Cited by 21 publications

References 19 publications

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

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

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

Papillae, psammoma bodies, and/or many nuclear pseudoinclusions are helpful criteria but should not be required for a definitive cytologic diagnosis of papillary thyroid carcinoma: An institutional experience of 207 cases with surgical follow up

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