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Suggesting the cytologic diagnosis of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP): A retrospective analysis of atypical and suspicious nodules.

Publication ,  Journal Article
Strickland, KC; Howitt, BE; Barletta, JA; Cibas, ES; Krane, JF
Published in: Cancer Cytopathol
February 2018

BACKGROUND: The term "noninvasive follicular thyroid neoplasm with papillary-like nuclear features" (NIFTP) has replaced a subset of follicular variant of papillary thyroid carcinoma due to the indolent behavior of such tumors. NIFTPs are most often classified in an "indeterminate" diagnostic category. In the current study, the authors sought to identify cytologic features helpful in distinguishing NIFTP from other entities in these categories, particularly benign nodules. METHODS: The authors retrospectively evaluated a consecutive cohort of 130 thyroid fine-needle aspiration (FNA) specimens with an indeterminate diagnosis and available histopathologic follow-up. All FNA specimens were evaluated using the ThinPrep method. Each FNA was blindly reviewed by 2 board-certified cytopathologists, who assessed overall cellularity; architectural parameters; and nuclear features, including nuclear pallor and fine chromatin, distinct nucleoli, and irregular nuclear membranes. Each case received a score of 0 to 3, based on the presence or absence of these 3 nuclear features. RESULTS: Nuclear but not architectural features appeared to distinguish NIFTP from benign nodules. Ninety-one percent of the NIFTPs (32 of 35 NIFTPs) received a score of ≥2, compared with 35% of benign nodules (23 of 66 benign nodules) (P<.0001). In contrast, NIFTP could not be differentiated from the invasive/infiltrative follicular variant of papillary thyroid carcinoma using these criteria (P = 1.000). Nuclear scoring was found to be especially useful in atypia of undetermined significance/follicular lesion of undetermined significance (AUS); a score ≥2 enriched for NIFTP (39% vs 3% of AUS cases with a score <2), whereas a score <2 was more likely benign (85% vs 50% of AUS cases with a score ≥2). CONCLUSIONS: In indeterminate FNA specimens, the distinction of a possible NIFTP from a benign thyroid nodule can be suggested using a simple nuclear scoring system that is most valuable in AUS aspirates. Cancer Cytopathol 2018;126:86-93. © 2017 American Cancer Society.

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Published In

Cancer Cytopathol

DOI

EISSN

1934-6638

Publication Date

February 2018

Volume

126

Issue

2

Start / End Page

86 / 93

Location

United States

Related Subject Headings

  • Thyroid Nodule
  • Thyroid Neoplasms
  • Thyroid Gland
  • Thyroid Cancer, Papillary
  • Retrospective Studies
  • Middle Aged
  • Male
  • Lymphatic Metastasis
  • Lymph Nodes
  • Humans
 

Citation

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Strickland, K. C., Howitt, B. E., Barletta, J. A., Cibas, E. S., & Krane, J. F. (2018). Suggesting the cytologic diagnosis of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP): A retrospective analysis of atypical and suspicious nodules. Cancer Cytopathol, 126(2), 86–93. https://doi.org/10.1002/cncy.21922
Strickland, Kyle C., Brooke E. Howitt, Justine A. Barletta, Edmund S. Cibas, and Jeffrey F. Krane. “Suggesting the cytologic diagnosis of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP): A retrospective analysis of atypical and suspicious nodules.Cancer Cytopathol 126, no. 2 (February 2018): 86–93. https://doi.org/10.1002/cncy.21922.
Strickland, Kyle C., et al. “Suggesting the cytologic diagnosis of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP): A retrospective analysis of atypical and suspicious nodules.Cancer Cytopathol, vol. 126, no. 2, Feb. 2018, pp. 86–93. Pubmed, doi:10.1002/cncy.21922.
Journal cover image

Published In

Cancer Cytopathol

DOI

EISSN

1934-6638

Publication Date

February 2018

Volume

126

Issue

2

Start / End Page

86 / 93

Location

United States

Related Subject Headings

  • Thyroid Nodule
  • Thyroid Neoplasms
  • Thyroid Gland
  • Thyroid Cancer, Papillary
  • Retrospective Studies
  • Middle Aged
  • Male
  • Lymphatic Metastasis
  • Lymph Nodes
  • Humans