A pathologic re-review of follicular thyroid neoplasms: The impact of changing the threshold for the diagnosis of the follicular variant of papillary thyroid carcinoma

Surgery ◽  
2008 ◽  
Vol 144 (1) ◽  
pp. 80-85 ◽  
Author(s):  
Sandy Widder ◽  
Kelly Guggisberg ◽  
Moosa Khalil ◽  
Janice L. Pasieka
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Thyroid Neoplasms ◽  
Papillary Thyroid ◽  
Follicular Variant ◽  
The Impact

scholarly journals The History of the Follicular Variant of Papillary Thyroid Carcinoma

2016 ◽  
Vol 102 (1) ◽  
pp. 15-22 ◽  
Author(s):  
Giovanni Tallini ◽  
R. Michael Tuttle ◽  
Ronald A. Ghossein
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Historical Context ◽  
Papillary Thyroid ◽  
Follicular Variant ◽  
Recent Developments ◽  
Pubmed Search ◽  
History Of ◽  
The Impact

Abstract Context: This review provides historical context to recent developments in the classification of the follicular variant of papillary thyroid carcinoma (FVPTC). The evolution of the diagnostic criteria for papillary thyroid carcinoma is described, clarifying the role of molecular analysis and the impact on patient management. Methods: A PubMed search using the terms “follicular variant” and “papillary thyroid carcinoma” covering the years 1960 to 2016 was performed. Additional references were identified through review of the citations of the retrieved articles. Results: The encapsulated/well-demarcated, noninvasive form of FVPTC that occurs annually in 45,000 patients worldwide was thought for 30 years to be a carcinoma. Many studies have shown almost no recurrence in these noninvasive tumors, even in patients treated by surgery alone without radioactive iodine therapy. The categorization of the tumor as outright cancer has led to aggressive forms of treatment, with their side effects, financial costs, and the psychological and social impacts of a cancer diagnosis. Recently, the encapsulated/well-demarcated, noninvasive FVPTC was renamed as noninvasive follicular thyroid neoplasm with papillary-like nuclear features. The new terminology lacks the carcinoma label, enabling clinicians to avoid aggressive therapy. Conclusions: By understanding the history of FVPTC, future classification of tumors will be greatly improved.

scholarly journals The Impact of Noninvasive Follicular Variant of Papillary Thyroid Carcinoma on Rates of Malignancy for Fine-Needle Aspiration Diagnostic Categories

Thyroid ◽  
2015 ◽  
Vol 25 (9) ◽  
pp. 987-992 ◽  
Author(s):  
Kyle C. Strickland ◽  
Brooke E. Howitt ◽  
Ellen Marqusee ◽  
Erik K. Alexander ◽  
Edmund S. Cibas ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Papillary Thyroid ◽  
Follicular Variant ◽  
Fine Needle ◽  
Diagnostic Categories ◽  
The Impact

scholarly journals Galectin-3 Immunohistochemical Expression in Thyroid Neoplasms – A Study from Kalaburagi, Karnataka

2021 ◽  
Vol 8 (26) ◽  
pp. 2288-2293
Author(s):  
Anuradha G. Patil ◽  
Saniya Jahan ◽  
Syed Mukhtar Mohiuddin
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Follicular Carcinoma ◽  
Thyroid Neoplasms ◽  
Malignant Neoplasms ◽  
Benign Neoplasms ◽  
Papillary Thyroid ◽  
Follicular Variant ◽  
Galectin 3 ◽  
Malignant Thyroid Neoplasms

BACKGROUND Thyroid carcinoma is the most common endocrine malignancy. Galectin-3 has been implicated in malignant transformation and metastasis of cancer cells and it has received notable recognition for its usefulness as a diagnostic marker for thyroid cancer. We wanted to evaluate the expression of Galectin-3 on thyroid neoplasms, establish its diagnostic accuracy and also differentiate between benign and malignant thyroid lesions. METHODS A total of 54 thyroidectomy specimens were studied over a period of 3 years (2016 - 2019) which included 20 benign and 34 malignant thyroid neoplasms. Histopathologic evaluation of H & E stained sections was done and immunohistochemistry (IHC) staining for Galectin-3 was performed for all neoplasms with the polymeric method using lyophilized mouse monoclonal antibody. (Path n Situ) and grading based on intensity of Galectin-3 expression were noted. RESULTS Galectin-3 expression was significantly higher (P < 0.001) in malignant thyroid neoplasms in comparison to the benign neoplasms. Galectin-3 expression for malignant neoplasms showed sensitivity of 88.23 %, specificity of 95.0 %, positive predictive value (PPV) of 96.8 % and negative predictive value (NPV) of 82.6 %. Galectin-3 expression in Papillary thyroid carcinoma showed a sensitivity of 95.83 % and PPV of 88.2 %. While comparing the neoplasms showing follicular pattern, Galectin-3 expression was more in the malignant neoplasms (follicular carcinoma and follicular variant of papillary carcinoma thyroid) than benign neoplasms (follicular adenoma). CONCLUSIONS Galectin-3 is a useful marker in differentiating benign and malignant thyroid neoplasms. Galectin-3 is sensitive for Papillary thyroid carcinoma (PTC) and among the follicular patterned lesions, Galectin-3 is sensitive for follicular variant of papillary carcinoma and follicular carcinoma. Thus Galectin-3 protein expression evaluated using immunohistochemistry technique acts as an adjunctive ancillary technique in thyroid cancer diagnosis. KEYWORDS Galectin-3, Immunohistochemistry, Thyroid Carcinoma, Papillary Thyroid Carcinoma

Utility of Tumor Capsule Thickness as a Predictor of Invasion in Encapsulated Follicular Variant of Papillary Thyroid Carcinoma and a Diagnostic Tool for Noninvasive Follicular Thyroid Neoplasm With Papillary-Like Nuclear Features

2019 ◽  
Vol 28 (1) ◽  
pp. 13-19 ◽  
Author(s):  
Brenda French ◽  
Georgette Hattier ◽  
Stacey K. Mardekian
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Predictive Marker ◽  
Thyroid Neoplasms ◽  
Thyroid Neoplasm ◽  
Papillary Thyroid ◽  
Follicular Variant ◽  
Tumor Capsule ◽  
Capsule Thickness ◽  
Nuclear Features

Context. Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is an extremely indolent subset of noninvasive encapsulated follicular variant of papillary thyroid carcinoma (EFVPTC). These lesions share certain features including a delimiting fibrous capsule, and they are distinguished by detailed histological criteria. Objective. We sought to identify whether tumor capsule thickness differs significantly between NIFTP and noninvasive EFVPTC lesions. We also compared tumor capsule thickness between noninvasive and invasive EFVPTC in order to evaluate its utility as a predictive marker of invasion. Design. Encapsulated follicular thyroid neoplasms with papillary-like nuclear features diagnosed over a 3-year period at a single institution were subcategorized into NIFTP, noninvasive EFVPTC, and invasive EFVPTC based on current diagnostic criteria. Maximum tumor capsule thickness for each lesion was measured. Results. A total of 92 lesions (39 NIFTP, 15 noninvasive EFVPTC, and 38 invasive EFVPTC) were evaluated. Tumor capsule thickness was significantly thinner in NIFTP ( P = .022) and significantly thicker in invasive EFVPTC ( P = .0006) when compared with noninvasive EFVPTC. Conclusions. Tumor capsule thickness may be an additional useful marker when distinguishing between NIFTP and noninvasive EFVPTC. A capsule thickness of greater than 0.2 mm should raise suspicion for EFVPTC and thus prompt more thorough review of the submitted tissue for NIFTP exclusionary criteria. Additionally, if capsular and/or vascular invasion are not present on initial slides of an entirely evaluated capsule of EFVPTC that exceeds 0.5 mm in thickness, the pathologist should order additional tissue levels to ensure that a small focus of invasion is not missed.

Cytological Diagnosis of Follicular Variant of Papillary Thyroid Carcinoma before and after the Bethesda System for Reporting Thyroid Cytopathology

2016 ◽  
Vol 60 (1) ◽  
pp. 14-18 ◽  
Author(s):  
Roghayeh Fazeli ◽  
Christopher J. VandenBussche ◽  
Justin A. Bishop ◽  
Syed Z. Ali
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Surgical Resection ◽  
Follicular Neoplasm ◽  
Papillary Thyroid ◽  
Follicular Variant ◽  
Bethesda System ◽  
Thyroid Cytopathology ◽  
The Bethesda System ◽  
The Impact

Background: The follicular variant of papillary thyroid carcinoma (FVPTC) is the second most common subtype of papillary carcinoma after the classical variant. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) has been introduced to standardize the practice of thyroid fine needle aspiration (FNA) reporting. We evaluated the impact of TBSRTC on the FNA interpretation of histologically proven FVPTCs. Method: Cytology reports of 455 histologically proven FVPTCs were reviewed. The rate of each TBSRTC category was compared between pre- and post-TBSRTC eras. Results: The distribution of FNA diagnoses for pre-TBSRTC cases included suspicious for follicular neoplasm (SFN; n = 51, 28.7%), papillary thyroid carcinoma (PTC; n = 47, 26.4%), suspicious for malignancy (SFM; n = 32, 18%), atypia of undetermined significance (AUS; n = 23, 13%), benign (n = 18, 10.1%), and nondiagnostic (ND; n = 7, 4%). Post-TBSRTC diagnoses were: AUS (n = 68, 24.6%), PTC (n = 64, 23.1%), SFM (n = 50, 18%), SFN and benign (n = 42, 15.2%) and ND (n = 11, 4%). SFN rate decreased significantly from 28.7 to 15.2% (p = 0.001) and AUS increased from 12.9 to 24.5% (p = 0.003). Conclusion: Following implementation of TBSRTC, the frequency of AUS diagnoses on FNA prior to surgical resection increased. Given that the rate of FVPTC diagnoses on thyroidectomy increased over the same period, this suggests that the use of AUS has resulted in greater surgical resection of FVPTC.

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