Rate of non-invasive follicular thyroid neoplasms with papillary-like nuclear features depends on pathologist’s criteria: a multicentre retrospective Southern European study with prolonged follow-up

Endocrine ◽  
2021 ◽  
Author(s):  
Miguel Paja ◽  
Carles Zafón ◽  
Carmela Iglesias ◽  
Aitziber Ugalde ◽  
Jose Manuel Cameselle-Teijeiro ◽  
...  
Keyword(s):  
Thyroid Neoplasms ◽  
European Study ◽  
Non Invasive ◽  
Nuclear Features

scholarly journals Case Report: Multifocal non-invasive follicular thyroid neoplasm with papillary-like nuclear features presenting in a female child

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 645
Author(s):  
Asmaa Gaber Abdou ◽  
Hayam Aiad ◽  
Nancy Asaad
Keyword(s):  
Present Report ◽  
Female Child ◽  
Nodal Metastasis ◽  
Thyroid Neoplasm ◽  
World Health ◽  
Non Invasive ◽  
Paediatric Age ◽  
Health Organization ◽  
Nuclear Features

Non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) was introduced as a separate entity by the World Health Organization in 2017 with strict inclusion and exclusion criteria.  Most NIFTP cases have been reported in adults and few cases have been diagnosed in children. Here, we present a classic case of NIFTP affecting a 10-year old female child. We also review previous reports of NIFTP in children regarding size, focality, nodal metastasis, recurrence, type of operation and follow-up data. The present report adds a new case of NIFTP in the paediatric age group characterized by multifocality, absence of nodal invasion and indolent course until last follow-up, recommending less aggressive management.

HBME1 and CK19 in Non-Invasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features (NIFTP) vs Other Follicular Patterned Thyroid Lesions.

2021 ◽  
Author(s):  
Qandeel Sadiq ◽  
Radhika Sekhri ◽  
Daniel Dibaba ◽  
Qi Zhao ◽  
Shweta Agarwal
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Follicular Adenoma ◽  
Thyroid Neoplasms ◽  
University Hospital ◽  
Thyroid Neoplasm ◽  
Papillary Thyroid ◽  
Non Invasive ◽  
Significant Difference ◽  
Nuclear Features

Abstract Background: Thyroid neoplasms with follicular architecture can have overlapping morphologic features and pose diagnostic confusion amongst pathologists. Various immunohistochemical stains have been investigated as potential diagnostic markers for PTC; amongst which HBME1 and CK19 have gained popularity. Non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) poses similar diagnostic challenges with interobserver variability and is often misdiagnosed as adenomatoid nodule or follicular adenoma. This study aims to evaluate expression of HBME1 and CK19 in NIFTPs in comparison to other well differentiated thyroid neoplasms and benign mimickers. Method: 73 thyroid cases diagnosed over a period of 3 years at Methodist University Hospital, Memphis, TN were included in this study: 9 NIFTP, 18 papillary thyroid carcinoma (PTC), 11 follicular variant of papillary thyroid carcinoma, invasive (I-FVPTC), 24 follicular adenomas (FA), and 11 multinodular goiters/ adenomatoid nodules (MNG). A tissue microarray (TMA) was constructed and HBME1 and CK19 IHC was performed.Results: HBME1 was expressed in 77.8% NIFTPs, 88.9% PTC, 81.8% I-FVPTC, 16.7 % FA, and 18.2% MNGs. CK19 expression was seen in 66.7% NIFTPs, 83.3% PTC, 81.8% I-FVPTC, 33.3% FA and 45.4% MNGs. Difference in expression of HBME1 and CK19 was statistically significant for NIFTP vs FA (qualitative; p<0.05) and NIFTP vs MNG (p<0.05). No statistically significant difference was found for HBME1 in NIFTP vs PTC (conventional and FVPTC), p>/= 0.2. Sensitivity of HBME1 and CK19 for NIFTP were 78% and 67%, ~88% each for PTC, and 89% and 100% for FVPTC respectively, while specificity of HBME1 and CK19 for NIFTP were 53% each, ~62% each for PTC and ~55% each for FVPTC. Conclusion: Our study indicated that HBME1 and CK19 are valuable markers in differentiating NIFTPs from morphologic mimics like follicular adenoma and adenomatoid nodules/ multinodular goiter. While HBME1 and CK19 are both sensitive in diagnosing lesions with PTC like nuclear features, CK19 stains a higher number of benign lesions in comparison to HBME1. No increase in sensitivity or specificity in diagnosis of NIFTP, PTC or FVPTC was noted on combining the two antibodies.

scholarly journals Clinical-Pathological and Molecular Evaluation of 451 NIFTP Patients from a Single Referral Center

Cancers ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 420
Author(s):  
Paola Vignali ◽  
Agnese Proietti ◽  
Elisabetta Macerola ◽  
Anello Marcello Poma ◽  
Liborio Torregrossa ◽  
...  
Keyword(s):  
Retrospective Cohort ◽  
Thyroid Neoplasms ◽  
Molecular Profile ◽  
Follicular Neoplasm ◽  
Cytological Diagnosis ◽  
Careful Monitoring ◽  
Non Invasive ◽  
Indeterminate Cytology ◽  
Nuclear Features ◽  
Molecular Evaluation

Background: Non-invasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTPs) were introduced in thyroid pathology in 2016. NIFTPs are a group of follicular neoplasm with an indolent behaviour. In this study, we gathered a large retrospective cohort of NIFTPs and compared those presenting as solitary lesions and NIFTPs found in multifocal setting. Methods: A retrospective search of NIFTPs was performed, and the clinico-pathological features were recorded. For a subgroup of patients, pre-surgical ultrasound (US) evaluation, cytological diagnosis, and molecular analysis were available. Results: We collected 451 NIFTPs; 254 (56.3%) were truly solitary tumours, while 197 coexisted with one or more NIFTP/cancer. Contrasting unifocal and multifocal settings, NIFTPs size was the only significantly different parameter. Preoperatively, NIFTP nodules mostly showed low-risk US characteristics, indeterminate cytology and a RAS-like molecular profile. Conclusion: NIFTPs often coexist with collateral thyroid tumours. However, no clinical-pathological differences can be observed between solitary and “multifocal” NIFTPs. Despite the well-established clinical indolence of NIFTP, a careful monitoring of the contralateral lobe should not be excluded.

scholarly journals Impact of non-invasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTP) on risk of malignancy in patients undergoing lobectomy/thyroidectomy for suspected malignancy or malignant fine-needle aspiration cytology findings: a systematic review and meta-analysis

2019 ◽  
Vol 181 (4) ◽  
pp. 389-396 ◽  
Author(s):  
Massimo Bongiovanni ◽  
William C Faquin ◽  
Luca Giovanella ◽  
Cosimo Durante ◽  
Peter Kopp ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Thyroid Neoplasms ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Diagnostic Categories ◽  
Non Invasive ◽  
Risk Of Malignancy ◽  
Needle Aspiration Cytology ◽  
Nuclear Features

Objective The second version of The Bethesda System for Reporting Thyroid Cytopathology endorsed the introduction of non-invasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTP) as a distinct entity with low malignant potential into clinical practice. Consequently, the risk of malignancy (ROM) of cytological diagnoses has changed, but the magnitude of the change remains uncertain. The present systematic review was undertaken to obtain more robust information about the true impact of NIFTP on the ROM among patients undergoing surgery following a fine-needle aspiration cytology (FNAC) diagnosis of suspicious for malignancy (Bethesda V) or malignant (Bethesda VI). As they are managed surgically, these two diagnostic categories are the primary entities that are clinically impacted by the advent of NIFTP. Design Systematic review and meta-analysis. Methods A comprehensive literature search of online databases was performed in November 2018. The search was conducted looking for data of histologically proven NIFTP with preoperative FNAC. Results One-hundred fifty-seven articles were identified and nine were included in the study. Overall, there were 13,752 thyroidectomies with a cancer prevalence of 45.7%. When NIFTP was considered non-malignant, the pooled risk difference for ROM was 5.5%. Applying meta-analysis, the pooled prevalence of NIFTP among nodules with FNAC of Bethesda V or Bethesda VI was 14 and 3%, respectively. Conclusion This meta-analysis shows that the inclusion of NIFTP leads to a reduction in the ROM for the Bethesda V and Bethesda VI FNAC diagnostic categories by 14 and 3%, respectively. Clinicians should be aware of these data to avoid overtreatment.

scholarly journals DETECTION OF AUTOANTIBODIES RECOGNIZING CANCERRETINA ANTIGEN RECOVERIN IN BLOOD OF PATIENTS WITH NON-INVASIVE FOLLICULAR THYROID NEOPLASMS WITH PAPILLARY-LIKE NUCLEAR FEATURES (NIFTP)

2019 ◽  
Vol 21 (4) ◽  
pp. 781-788
Author(s):  
P. V. Belousov ◽  
Ya. I. Bobrovskaya ◽  
A. V. Bogolyubova ◽  
A. Yu. Sazykin ◽  
Yu. V. Shebzukhov ◽  
...  
Keyword(s):  
Clinical Evidence ◽  
Thyroid Neoplasms ◽  
Thyroid Tumors ◽  
Healthy Individuals ◽  
Low Frequencies ◽  
Non Invasive ◽  
Potential Biomarker ◽  
Cancer Associated Retinopathy ◽  
Dot Elisa ◽  
Nuclear Features

Autoantibodies recognizing the cancer-retina autoantigen called recoverin (RCVRN-AutoAb) may serve as a highly specific biomarker of cancer-associated retinopathy. However, they may also be found in some cancer patients without clinical evidence of retinopathy. In the present study, dot-ELISA and Western blot assays were used to demonstrate the presence of circulating RCVRN-AutoAb in 4/7 (57%) of patients with recently recognized pathological entity, non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP); other thyroid tumors represented by follicular adenomas, and classical and follicular variants of papillary thyroid carcinomas, demonstrated low frequencies of RCVRN-AutoAb (0/15, 1/20 (5%) and 1/15 (7%), respectively), with no significant differences from healthy individuals (0/15). Our data implicate the circulating RCVRN-AutoAb as a potential biomarker of NIFTP capable of discrimination of this novel pathological entity from other thyroid tumors.

scholarly journals Non Invasive Follicular Thyroid Neoplasm with Papillary like nuclear features (NIFTP)

2019 ◽  
Vol 36 (2) ◽  
Author(s):  
Sumerah Jabeen ◽  
Saira Fatima ◽  
Aisha Sheikh ◽  
Najmul Islam
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Systemic Disease ◽  
Tertiary Care ◽  
Disease Recurrence ◽  
Thyroid Neoplasm ◽  
Papillary Thyroid ◽  
Non Invasive ◽  
Nuclear Features

Objective: To determine the cases of Noninvasive Follicular thyroid neoplasm with papillary like nuclear features (NIFTP) in Pakistani population retrospectively. Another objective was to determine their clinical and radiological outcomes with respect to local and systemic disease recurrence, reconfirming the benign course of this new nomenclature in Thyroid tumors by WHO in our population would encourage adopting the new conservative treatment approach in such patients. Methods: This is a retrospective cohort study conducted at a tertiary care center in Karachi, Pakistan from 2007-2016. All follicular Variant papillary thyroid cancer (FVPTC) reported from a single institute had their histopathology slides reexamined for diagnosing NIFTP as per the new WHO criteria. These cases were then followed retrospectively from their diagnosis onset through their medical and electronic health record for any local or systemic disease recurrence. Results: There were 199 cases of Papillary Thyroid cancer (PTC) which included 22 cases of FVPTC. Eleven cases fulfilled NIFTP criteria with tumor size ranging from 1.1cm to ≥ 5.5cm. All patients in the NIFTP group underwent total thyroidectomy. Nine patients (81.81%) received RAI131 therapy. Four (45%) patients had a median follow up of three to four years. There was no disease recurrence seen on both ultrasound and RAI scans of patients in the NIFTP group. Seven patients (87.5%) had normal surveillance thyroglobulin levels except one whereas three patients were lost to follow up. There was no disease recurrence seen both radiologically and biochemically in the NIFTP group. Conclusion: Our study favors the low risk nature of NIFTP with no disease recurrence in the cases studied and encourages de-escalation of treatment. doi: https://doi.org/10.12669/pjms.36.2.1123 How to cite this:Jabeen S, Fatima S, Sheikh A, Islam N. Non Invasive Follicular Thyroid Neoplasm with Papillary like nuclear features (NIFTP), A time for change in Pakistan. Pak J Med Sci. 2020;36(2):---------. doi: https://doi.org/10.12669/pjms.36.2.1123 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals HBME1 and CK19 expression in non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) vs other follicular patterned thyroid lesions

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Qandeel Sadiq ◽  
Radhika Sekhri ◽  
Daniel T. Dibaba ◽  
Qi Zhao ◽  
Shweta Agarwal
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Follicular Adenoma ◽  
Thyroid Neoplasms ◽  
University Hospital ◽  
Thyroid Neoplasm ◽  
Papillary Thyroid ◽  
Non Invasive ◽  
Significant Difference ◽  
Nuclear Features

Abstract Background Thyroid neoplasms with follicular architecture can have overlapping morphologic features and pose diagnostic confusion among pathologists. Various immunohistochemical stains have been investigated as potential diagnostic markers for PTC, among which HBME1 and CK19 have gained popularity. Non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) poses similar diagnostic challenges with interobserver variability and is often misdiagnosed as adenomatoid nodule or follicular adenoma. This study aims to evaluate expression of HBME1 and CK19 in NIFTPs in comparison to other well-differentiated thyroid neoplasms and benign mimickers. Method Seventy-three thyroid cases diagnosed over a period of 3 years at Methodist University Hospital, Memphis, TN, USA, were included in this study: 9 NIFTP; 18 papillary thyroid carcinoma (PTC); 11 follicular variant of papillary thyroid carcinoma, invasive (I-FVPTC); 24 follicular adenomas (FA); and 11 multinodular goiters/adenomatoid nodules (MNG). A tissue microarray (TMA) was constructed and HBME1 and CK19 immunohistochemistry was performed. Results 77.8% of NIFTPs, 88.9% of PTCs, 81.8% of I-FVPTCs, 16.7% of FAs, and 18.2% of MNGs showed HBME-1 expression. 66.7% of NIFTPs, 83.3% of PTCs, 81.8% of I-FVPTCs, 33.3% of FAs, and 45.4% of MNGs expressed CK19. Difference in expression of HBME1 and CK19 was statistically significant for NIFTP vs FA (qualitative; p < 0.05) and NIFTP vs MNG (p < 0.05). No statistically significant difference was found for HBME1 in NIFTP vs PTC (conventional and FVPTC), p ≥ 0.2. Sensitivity of HBME1 and CK19 for NIFTP were 78% and 67%, ~ 88% each for PTC, and 89% and 100% for FVPTC, respectively, while specificity of HBME1 and CK19 for NIFTP were 53% each, ~ 62% each for PTC, and ~55% each for FVPTC. Conclusion Our study indicated that HBME1 and CK19 are valuable markers in differentiating NIFTPs from morphologic mimics like follicular adenoma and adenomatoid nodules/multinodular goiter. While HBME1 and CK19 are both sensitive in diagnosing lesions with PTC-like nuclear features, CK19 stains a higher number of benign lesions in comparison to HBME1. No increase in sensitivity or specificity in diagnosis of NIFTP, PTC, or FVPTC was noted on combining the two antibodies.

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