Thyroid nodules with FNA cytology suspicious for follicular variant of papillary thyroid carcinoma: Follow-up and management

2000 ◽  
Vol 23 (6) ◽  
pp. 380-385 ◽  
Author(s):  
Sanjay Logani ◽  
Prabodh K. Gupta ◽  
Virginia A. LiVolsi ◽  
Susan Mandel ◽  
Zubair W. Baloch
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Thyroid Nodules ◽  
Papillary Thyroid ◽  
Follicular Variant

scholarly journals Effect of Implementing the New Diagnostic Criteria for Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features in King Abdulaziz University Hospital

2016 ◽  
Vol 23 (3) ◽  
pp. 31-37
Author(s):  
Fatimah A. Alturkistani ◽  
Murad A. Alturkustani
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Diagnostic Criteria ◽  
University Hospital ◽  
Thyroid Neoplasm ◽  
Papillary Thyroid ◽  
Follicular Variant ◽  
King Abdulaziz University ◽  
Nuclear Features

Pathological diagnosis of follicular variant of papillary thyroid carcinoma has high inter and intra-observer variability among expert pathologists, aff ecting prognosis and management of the disease. A recent study applying strict diagnostic criteria and long-term follow up confi rmed the indolent behavior of a subtype of these tumors. They recommended a nomenclature change to noninvasive follicular thyroid neoplasm with papillary-like nuclear features, refl ecting the low risk of adverse outcomes. We searched the pathology archives of King Abdulaziz University Hospital from 2002-2016 for all cases diagnosed with “follicular variant of papillary thyroid carcinoma”. Clinical data, and imaging fi ndings were retrospectively reviewed. Available pathologyslides were reviewed using the proposed inclusion and exclusion diagnostic criteria. We confi rmed the diagnostic reproducibility of the suggested criteria. Ten out of 37 cases met the diagnostic criteria. Eightadditional patients could have had their diagnosis modifi ed if sufficient tissue samples were available. Follow up data confi rmed the indolent behavior in these cases with no recurrence or adverse outcome. We concluded that application of the new diagnostic criteria for this subtype is reasonable and has major ramifi cations for the diagnosis and management as this will spare unnecessary thyroidectomies, radioactive iodine therapy, and their complications.

scholarly journals Diffuse Follicular Variant of Papillary Thyroid Carcinoma: A Case Report with a Revision of Literature

Rare Tumors ◽  
2016 ◽  
Vol 8 (4) ◽  
pp. 159-161 ◽  
Author(s):  
Gian Luca Rampioni Vinciguerra ◽  
Niccolò Noccioli ◽  
Armando Bartolazzi
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Young Women ◽  
Unusual Case ◽  
Thyroid Nodules ◽  
Papillary Thyroid ◽  
Follicular Variant ◽  
Few Data ◽  
Thyroid Parenchyma ◽  
Nuclear Features

The diffuse follicular variant of papillary thyroid carcinoma (DFV-PTC) is a rare malignant thyroid condition. It represents an uncommon variant of papillary carcinoma characterized by a diffuse involvement of thyroid parenchyma, follicular architecture and nuclear features of PTC in absence of a surrounding capsule. Up to date few data have been collected about this entity and, at the best of our knowledge, only 24 cases have been reported in the literature. According to these reports DFV-PTC seems to occur preferentially in young women and shows more aggressive behavior than other papillary thyroid tumors. Herein we present an unusual case of DFV-PTC occurring in an 83 years old woman, involving the entire thyroid gland, without distinct or prevalent thyroid nodules. The tumor was clinically misdiagnosed as obstructive goiter.

scholarly journals Preoperative RAS Mutational Analysis Is of Great Value in Predicting Follicular Variant of Papillary Thyroid Carcinoma

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Tae Sook Hwang ◽  
Wook Youn Kim ◽  
Hye Seung Han ◽  
So Dug Lim ◽  
Wan-Seop Kim ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Thyroid Nodules ◽  
Mutational Analysis ◽  
Braf V600e ◽  
Papillary Thyroid ◽  
Follicular Variant ◽  
Ras Mutation ◽  
Ras Mutations ◽  
Codon 61

Follicular variant of papillary thyroid carcinoma (FVPTC), particularly the encapsulated subtype, often causes a diagnostic dilemma. We reconfirmed the molecular profiles in a large number of FVPTCs and investigated the efficacy of the preoperative mutational analysis in indeterminate thyroid nodules. BRAF V600E/K601E and RAS mutational analysis was performed on 187 FVPTCs. Of these, 132 (70.6%) had a point mutation in one of the BRAF V600E (n=57), BRAF K601E (n=11), or RAS (n=64) genes. All mutations were mutually exclusive. The most common RAS mutations were at NRAS codon 61. FNA aspirates from 564 indeterminate nodules were prospectively tested for BRAF and RAS mutation and the surgical outcome was correlated with the mutational status. Fifty-seven and 47 cases were positive for BRAF and RAS mutation, respectively. Twenty-seven RAS-positive patients underwent surgery and all except one patient had FVPTC. The PPV and accuracy of RAS mutational analysis for predicting FVPTC were 96% and 84%, respectively. BRAF or RAS mutations were present in more than two-thirds of FVPTCs and these were mutually exclusive. BRAF mutational analysis followed by N, H, and KRAS codon 61 mutational analysis in indeterminate thyroid nodules would streamline the management of patients with malignancies, mostly FVPTC.

RAS mutations in indeterminate thyroid nodules are predictive of the follicular variant of papillary thyroid carcinoma

2014 ◽  
Vol 82 (5) ◽  
pp. 760-766 ◽  
Author(s):  
Jee Hyun An ◽  
Kee-Ho Song ◽  
Suk Kyeong Kim ◽  
Kyoung Sik Park ◽  
Young Bum Yoo ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Thyroid Nodules ◽  
Papillary Thyroid ◽  
Follicular Variant ◽  
Ras Mutations

New Concept of the Encapsulated Follicular Variant of Papillary Thyroid Carcinoma and Its Impact on the Bethesda System for Reporting Thyroid Cytopathology: A Single-Institute Experience

2016 ◽  
Vol 60 (3) ◽  
pp. 198-204 ◽  
Author(s):  
Sule Canberk ◽  
Pembegul Gunes ◽  
Mine Onenerk ◽  
Murat Erkan ◽  
Emine Kilinc ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Follicular Neoplasm ◽  
Papillary Thyroid ◽  
Follicular Variant ◽  
Bethesda System ◽  
The Subject ◽  
Thyroid Cytopathology ◽  
The Bethesda System

Background: The encapsulated follicular variant (EFV) of papillary thyroid carcinoma (PTC) is the most discussed entity in thyroid pathology. Recently, the question of whether or not EFV-PTC is a malignant entity has been the subject of renewed discussion in the light of recent molecular and clinical studies. The aim of this study was to analyze the malignancy ratios of each category of the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) if EFV-PTC is no longer considered as a malignant entity. Materials and Methods: Data on thyroid fine-needle aspirations (n = 1,886) with surgical follow-up between 1999 and 2014 were studied. EFV-PTC cases constituted 27% (94/343) of the malignant cases. Results: Malignancy ratios were determined as nondiagnostic, benign, atypia/follicular lesion of undetermined significance, suspicious for follicular neoplasm/follicular neoplasm, suspicious for malignancy, and malignant categories of the TBSRTC in 13, 7, 45, 30, 72 and 98%, respectively. If EFV-PTC was not regarded as malignant, malignancy ratios would decrease to 6.5, 6, 30, 10, 48, and 87% for each category in the same order. Conclusions: The current study showed that the most significant decrease in relative malignancy ratios was seen in the suspicious for follicular neoplasm/follicular neoplasm category (66% relative decrease), but all categories represented a considerable decrease.

Papillary and follicular variant of papillary carcinoma of the thyroid: Initial presentation and response to therapy

2005 ◽  
Vol 132 (6) ◽  
pp. 840-844 ◽  
Author(s):  
Alan R. Burningham ◽  
Jayashree Krishnan ◽  
Bruce J. Davidson ◽  
Matthew D. Ringel ◽  
Kenneth D. Burman
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Papillary Carcinoma ◽  
Intensive Therapy ◽  
Tumor Stage ◽  
Response To Therapy ◽  
Papillary Thyroid ◽  
Follicular Variant ◽  
Local Invasion

INTRODUCTION: The 2 most common histologic variants of papillary carcinoma are pure papillary carcinoma (PTC) and follicular variant of papillary thyroid carcinoma (FVPTC). The purpose of this study is to compare the presentation and short-term response to therapy of these variants and to determine if FVPTC is a more aggressive form of thyroid cancer that warrants intensive therapy. METHODS: A retrospective chart review of patients treated for PTC and FVPTC between 1996 and 1999 was performed. Clinical variables were compared with the Wilcoxon Rank-Sum test or the Fischer's Exact Test. RESULTS: Of 160 patients with papillary thyroid carcinoma included, 114 (71%) had PTC and 46 (29%) had FVPTC. Mean follow-up was 38.6 months. FVPTC presented with larger tumors (median 1.5 cm vs 1.0 cm, P = 0.007) and higher tumor stage than PTC. PTC patients were more likely to present with local invasion and to have local recurrence (9.65% vs 0% for both variables). There were no significant differences in patient age, gender, vascular invasion, lymph node or distant metastases, surgical treatment, radioactive iodine therapy, remission, or mortality. CONCLUSION: FVPTC presented with larger original tumor size and higher tumor stage but a lower local invasion rate and recurrence rate than patients with PTC despite similar therapies. These data suggest that FVPTC and PTC carry similar prognoses in early stages and that FVPTC may have a reduced predilection for local invasion. Although further studies with longer follow-up are required, these results do not suggest that FVPTC warrants more aggressive therapy than PTC.

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