1. bookVolume 64 (2018): Issue 3 (September 2018)
Journal Details
License
Format
Journal
eISSN
2668-7763
First Published
13 Aug 2013
Publication timeframe
6 times per year
Languages
English
access type Open Access

Histopathological Diagnostic Criteria for Non-invasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features Highlighted by Six Illustrative Cases

Published Online: 25 Sep 2018
Volume & Issue: Volume 64 (2018) - Issue 3 (September 2018)
Page range: 121 - 125
Received: 11 Jun 2018
Accepted: 25 Jul 2018
Journal Details
License
Format
Journal
eISSN
2668-7763
First Published
13 Aug 2013
Publication timeframe
6 times per year
Languages
English
Abstract

Introduction. The encapsulated, non-invasive subtype of follicular variant of papillary thyroid carcinoma (FVPTC) represents approximately 10% to 20% of all thyroid cancers. Many studies over the past decade have shown that these tumors carry an indolent clinical course, with no recurrence, even in patients treated by lobectomy. Their reclassification as neoplasms with “very low malignant potential” has recently been suggested by an international group of experts and a new terminology was proposed: “non-invasive follicular thyroid neoplasm with papillary-like nuclear features” (NIFTP). However, a diagnosis of NIFTP is still challenging for many pathologists in daily practice. Presentation of case series. By presenting six illustrative cases of NIFTP, this article aims to highlight the diagnostic criteria and the burden difficulties when dealing with NIFTP cases. Characteristic histological features, inclusion and exclusion criteria for NIFTP, as well as sampling guidelines and differential diagnosis challenges are all discussed. Conclusions. The diagnosis of NIFTP is not straightforward and requires meeting strict inclusion and exclusion criteria. Total sampling of the tumor capsule in these cases is mandatory in order to exclude invasion (capsular and/or vascular). A diagnosis of NIFTP promotes a less-aggressive patient management that is, no need for completion thyroidectomy or radioactive iodine therapy.

Keywords

1. Davies L, Welch HG - Current thyroid cancer trends in the United States. JAMA Otolaryngol Head Neck Surg. 2014;140(4):317-322.10.1001/jamaoto.2014.124557566Search in Google Scholar

2. Liu J, Singh B, Tallini G et al. - Follicular variant of papillary thyroid carcinoma: a clinicopathologic study of a problematic entity. Cancer. 2006;107:1255-1264.10.1002/cncr.2213816900519Search in Google Scholar

3. Howitt BE, Jia Y, Sholl LM, Barletta JA - Molecular alterations in partiallyencapsulated or well-circumscribed follicular variant of papillary thyroid carcinoma. Thyroid. 2013;23(10):1256-1262.10.1089/thy.2013.001823477374Search in Google Scholar

4. Rivera M, Tuttle RM, Patel S, Shaha A, Shah JP, Ghossein RA - Encapsulated papillary thyroid carcinoma: a clinico-pathologic study of 106 cases with emphasis on its morphologic subtypes (histologic growth pattern). Thyroid. 2009;19(2):119-127.10.1089/thy.2008.030319191744Search in Google Scholar

5. Rivera M, Ricarte-Filho J, Knauf J et al. - Molecular genotyping of papillary thyroid carcinoma follicular variant according to its histological subtypes (encapsulated vs infiltrative) reveals distinct BRAF and RAS mutation patterns. Mod Pathol. 2010;23(9):1191-1200.10.1038/modpathol.2010.112457346820526288Search in Google Scholar

6. Vivero M, Kraft S, Barletta JA - Risk stratification of follicular variant of papillary thyroid carcinoma. Thyroid. 2013;23(3):273-279.10.1089/thy.2012.036923025507Search in Google Scholar

7. Ganly I, Wang L, Tuttle RM et al. - Invasion rather than nuclear features correlates with outcome in encapsulated follicular tumors: further evidence for the reclassification of the encapsulated papillary thyroid carcinoma follicular variant. Hum Pathol. 2015;46(5):657-664.10.1016/j.humpath.2015.01.010498132925721865Search in Google Scholar

8. Burningham AR, Krishnan J, Davidson BJ, Ringel MD, Burman KD - Papillary and follicular variant of papillary carcinoma of the thyroid: Initial presentation and response to therapy. Otolaryngol Head Neck Surg. 2005;132(6):840-844.10.1016/j.otohns.2005.02.00215944551Search in Google Scholar

9. Rosario PW, Penna GC, Calsolari MR - Noninvasive encapsulated follicular variant of papillary thyroid carcinoma: is lobectomy sufficient for tumours >/=1 cm? Clin Endocrinol (Oxf). 2014;81(4):630-632.10.1111/cen.1238724350640Search in Google Scholar

10. Thompson LD - Ninety-four cases of encapsulated follicular variant of papillary thyroid carcinoma: A name change to Noninvasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features would help prevent overtreatment. Mod Pathol. 2016;29(7):698-707.10.1038/modpathol.2016.6527102347Search in Google Scholar

11. Nikiforov YE, Seethala RR, Tallini G et al. - Nomenclature Revision for Encapsulated Follicular Variant of Papillary Thyroid Carcinoma: A Paradigm Shift to Reduce Overtreatment of Indolent Tumors. JAMA Oncol. 2016;2(8):1023-1029.10.1001/jamaoncol.2016.0386553941127078145Search in Google Scholar

12. Nikiforov Y, Randolph G, Ghossein R, Tallini G, Kakudo K, Thompson LDR, LiVolsi V, Tuttle RM, Papotti M - Non-invasive follicular thyroid neoplasm with papillary-like nuclear features, in Lloyd RV, Osamura RY, Klopper JP, Rosai J (eds): WHO classification of tumors of endocrine organs. International Agency for Research on Cancer. Lyon, 2017, pg 78-80.Search in Google Scholar

13. Lloyd RV, Asa SL, LiVolsi VA et al. - The evolving diagnosis of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). Hum Pathol. 2018;74:1-4.10.1016/j.humpath.2017.12.02729339178Search in Google Scholar

14. Jung CK, Little MP, Lubin JH et al. - The increase in thyroid cancer incidence during the last four decades is accompanied by a high frequency of BRAF mutations and a sharp increase in RAS mutations. J Clin Endocrinol Metab. 2014;99(2):E276-E285.10.1210/jc.2013-250324187399Search in Google Scholar

15. Hung YP, Barletta JA - A user’s guide to non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). Histopathology. 2018;72:53-69.10.1111/his.1336329239036Search in Google Scholar

16. Kakudo K, El-Naggar AK, Hodak SP et al. - Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) in thyroid tumor classification. Pathol Int. 2018; 68(6):327-333.10.1111/pin.1267329675873Search in Google Scholar

17. Seethala RR, Baloch ZW, Barletta JA et al. - Noninvasive follicular thyroid neoplasm with papillary-like nuclear features: a review for pathologists. Mod Pathol. 2018;31:39-55.10.1038/modpathol.2017.13029052599Search in Google Scholar

Recommended articles from Trend MD

Plan your remote conference with Sciendo