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 ◽  
...  

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.

Diagnostics ◽  
2020 ◽  
Vol 11 (1) ◽  
pp. 43
Author(s):  
Armida Sodo ◽  
Martina Verri ◽  
Andrea Palermo ◽  
Anda Mihaela Naciu ◽  
Marialuisa Sponziello ◽  
...  

Follicular patterned nodules are sometimes complex to be classified due to ambiguous nuclear features and/or questionable capsular or vascular invasion. In this setting, there is a poor inter-observer concordance even among expert pathologists. Raman spectroscopy was recently used to separate benign and malignant thyroid nodules based on their molecular fingerprint; anyway, some histologically proved follicular adenomas were clustered as having a characteristic profile of malignant lesions. In this study, we analyzed five follicular thyroid adenomas with a malignant spectroscopic profile compared to five follicular adenomas with a benign Raman spectrum in order to assess possible molecular differences between the two groups. Morphological, immunohistochemical, and molecular analyses evidenced expression of malignancy-associated proteins in four out of five malignant clustered adenomas. The remaining malignant clustered adenoma showed a TSHR mutation previously associated with autonomously functioning follicular carcinomas. In conclusion, thyroid follicular adenomas are a group of morphologically benign neoplasms that may have altered the mutational or expression profile; cases of adenomas with altered immunophenotype are recognized as showing a profile associated with malignancy by Raman spectroscopy. This correlation warrants a more extensive evaluation and suggests a potential predictive value of spectroscopic assessment in recognizing characteristics associated with tumor progression in follicular thyroid neoplasms.


2018 ◽  
Vol 7 (5) ◽  
pp. S19-S20
Author(s):  
Diane Chen ◽  
Simon Sung ◽  
Elizabeth Margolskee ◽  
Patricia Tiscornia-Wasserman

Thyroid ◽  
2017 ◽  
Vol 27 (10) ◽  
pp. 1267-1276 ◽  
Author(s):  
Riccardo Giannini ◽  
Clara Ugolini ◽  
Anello Marcello Poma ◽  
Maria Urpì ◽  
Cristina Niccoli ◽  
...  

2021 ◽  
Author(s):  
Qandeel Sadiq ◽  
Radhika Sekhri ◽  
Daniel Dibaba ◽  
Qi Zhao ◽  
Shweta Agarwal

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.


2019 ◽  
Vol 181 (4) ◽  
pp. 389-396 ◽  
Author(s):  
Massimo Bongiovanni ◽  
William C Faquin ◽  
Luca Giovanella ◽  
Cosimo Durante ◽  
Peter Kopp ◽  
...  

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.


2019 ◽  
Vol 21 (4) ◽  
pp. 781-788
Author(s):  
P. V. Belousov ◽  
Ya. I. Bobrovskaya ◽  
A. V. Bogolyubova ◽  
A. Yu. Sazykin ◽  
Yu. V. Shebzukhov ◽  
...  

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.


2021 ◽  
pp. 1-21
Author(s):  
Elina Haaga ◽  
David Kalfert ◽  
Marie Ludvíková ◽  
Ivana Kholová

Background: A low-risk thyroid tumour, non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) was introduced in 2016. NIFTP criteria require a thorough histological examination to rule out capsular and lymphovascular invasion, which denies the possibility of preoperative cytological diagnosis. Nevertheless, since the adoption of the new entity, the cytology of NIFTP has been a subject of interest. Objectives: The present systematic review and meta-analysis investigate the cytological diagnosis of NIFTP. Method: An online PubMed literature search was conducted between March 1, 2020, and June 30, 2020, for all original articles considering the cytology of histologically proven NIFTP. The studies including data on fine needle aspiration specimens classified by The Bethesda System for Reporting Thyroid Cytology (TBSRTC) categories, risk of malignancy (ROMs) in the TBSRTC categories, and cytomorphological features of NIFTP were included in the meta-analysis. Non-English studies and case reports were excluded. The data were tabulated and statistical analysis was performed with Open Meta-Analyst program. Results: Fifty-eight studies with a total of 2,553 NIFTP cases were included in the study. The pooled prevalence of NIFTP cases was calculated among 25,892 surgically resected cases from 20 studies and the results show that NIFTP consisted 4.4% (95% confidence interval [CI]: 3.5–5.4%) of all cases. Most of the NIFTP cases (79.0%) belonged to the intermediate categories of TBSRTC. The pooled distribution of NIFTP cases in each TBSRTC category was 1.3% (95% CI: 0.8–1.7%) in non-diagnostic (ND), 8.9% (95% CI: 6.9–10.8%) in benign, 29.2% (95% CI: 25.0–33.4%) in atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS), 24.2% (95% CI: 19.6–28.9%) in follicular neoplasm (FN), 19.5% (95% CI: 16.1–22.9%) in suspicious for malignancy (SM), and 6.9% (95% CI: 5.2–8.7%) in malignant. Compared to pre-NIFTP era, the pooled risk differences of ROM were reduced by 2.4% in ND, 2.7% in benign, 8.2% in AUS/FLUS, 8.2% in FN, 7.3% in SM, and 1.1% in the malignant category. The cytomorphological features of NIFTP were similar to follicular variant of papillary thyroid carcinoma (FVPTC) but lesser to papillary thyroid carcinoma (PTC). Conclusions: Based on our results, NIFTP remains a histological diagnosis. Although cytomorphological features cannot be used in differentiating NIFTP from FVPTC, they may guide in separating NIFTP from PTC. Features such as papillae, microfollicles, giant cells, psammoma bodies, and the amount of papillary-like nuclear features should be taken into account when suspicious of NIFTP. NIFTP should not have papillae or psammoma bodies, and giant cells were rarely observed.


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