Ali SZ, Cibas ES. However, the term NIFTP in histological diagnosis is strictly stringent [20]. Bethesda system; FNA; NIFTP; cytopathology; thyroid. The newly termed tumor ‘noninvasive follicular thyroid neoplasm with papillary-like nuclear features’ (NIFTP) acts in an indolent manner and can likely be safely managed with a thyroid lobectomy. A total of 1,122 patients (40.3%) had corresponding histological results. <30% solid/trabecular/insular growth pattern, No tumor necrosis or high mitotic activityd, Lack of BRAF V600E mutation detected by molecular assays or immunohistochemistry, Lack of BRAF V600E-like mutations or other high-risk mutations (TERT, TP53). Malignant 97-99 94-96 Adapted from Ali and Cibas, TBSRTC, 2017 The revised Bethesda System MS, Calsolari … RR, Tallini WP, Bongers All Rights Reserved. Terms of Use| GF, Nunes Customize your JAMA Network experience by selecting one or more topics from the list below. In light of the recent publications, it is likely that a broader use of the “less than 1% papillae” criterion can lead to diagnosing tumors with biological and clinical characteristics of classic PTC as NIFTP. These cancers behave less … The purpose of this study was to establish preoperative clinical, laboratory, ultrasonographic, and cytological variables, which can differentiate NIFTP … Flowchart of case screening. (5)Davis Comprehensive Cancer Center, University of California, Davis Medical Center, Sacramento, CA, USA. NIFTP, noninvasive follicular thyroid neoplasm with papillary-like nuclear features; CA, carcinoma; FNA, fine-needle aspiration. T, Roman The present paper considers some aspects that are still debated or … For “NIFTP=Ca” and “NIFTP≠Ca”, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy were assessed. The recent reclassification of some thyroid neoplasms as non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) has implications for the risk of malignancy, and this is accounted for with regard to diagnostic criteria and optional notes. Bethesda, MD 20894, Copyright PTC nuclei were absent in 18%, focally present in 37.5%, and diffusely present in 44.4%. Although several studies published since the initial NIFTP report attest to low malignant potential of this tumor, cases of several patients with micrometastasis in regional lymph nodes and tumors apparently meeting the proposed diagnostic criteria for NIFTP have been reported. Characteristics of Reported Series With More Than 70 NIFTP Cases. -, Howitt BE, Chang S, Eszlinger M, et al Fine-needle aspiration diagnoses of noninvasive follicular variant of papillary thyroid carcinoma. Would you like email updates of new search results? 8-15, 17 Several studies have analyzed the … When "NIFTP=Ca", the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of TBSRTC were 98.0%, 84.0%, 99.4%, 58.3%, and 97.5%, respectively. The influence of the reclassification of NIFTP as an uncertain tumour on risk of malignancy for the diagnostic categories according to the Bethesda system for reporting thyroid cytopathology. doi: 10.21147/j.issn.1000-9604.2020.02.02. Parente Unable to load your collection due to an error, Unable to load your delegates due to an error. a Thick, thin, or partial capsule or well circumscribed with a clear demarcation from adjacent thyroid parenchyma. Why create a new name? RA. 1. NIFTP accounted for 0.4% of papillary thyroid carcinoma (PTC) cases, and there was no significant difference in the risk of malignancy (ROM) for each TBSRTC DC between "NIFTP=carcinoma (Ca)" and "NIFTP≠Ca". Cancer Cytopathol. YE, Seethala A similar approach should be used if BRAF V600E mutation is detected by immunohistochemistry. Author Contributions: Dr Nikiforov had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Am J Clin Pathol. A common theme in most studies of NIFTP, including a study by Zhou et al, 16 is the effect of NIFTP on the risk of malignancy for the different Bethesda categories. 2017;27:1341–6. U, Mete BR, Tuttle Prevention and treatment information (HHS). -, Faquin WC, Wong LQ, Afrogheh AH, et al Impact of reclassifying noninvasive follicular variant of papillary thyroid carcinoma on the risk of malignancy in the Bethesda System for Reporting Thyroid Cytopathology. Am J Clin Pathol. This site needs JavaScript to work properly. FN/SFN 25-40 10-40 V. Suspicious for Malignancy 50-75 45-60 VI. Three ultrasound phenotypes of non-invasive follicular thyroid neoplasm with papillary-like nuclear features proposed for imaging-pathology analysis: single center experience. When "NIFTP≠Ca", the sensitivity, specificity, PPV, NPV and accuracy of the TBSRTC were 98.1%, 81.5%, 99.3%, 61.1%, and 97.5%, respectively. -. Cytologically, because of the morphological overlap with other follicular neoplasms and with papillary thyroid carcinoma (PTC), most NIFTP are diagnosed … if NIFTP = CA (%) Risk of Malignancy if NIFTP ≠ CA (%) Usual Management ND or UNS 5-10 Repeat FNA with U/S Benign 0-3 Follow AUS or FLUS ~10–30 6-18 Repeat FNA or molecular testing SFN or FN 25-40 10-40 Lobectomy or molecular testing SUS for M 50-75 45-60 Thyroidectomy or lobectomy Malignant 97-99 94-96 Thyroidectomy or lobectomy • … 97-99% ~3-4% as PTC may prove to be NIFTP © 2021 American Medical Association. Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is an encapsulated or clearly delimited, noninvasive neoplasm with a follicular growth pattern and nuclear features of papillary thyroid carcinoma (PTC). Suspicious for Malignancy: 50-75%. Get free access to newly published articles. Papillary and follicular cancers are considered differentiated cancers, and patients with these tumors are often treated similarly despite numerous biologic differences. Zhou H, Baloch ZW, Nayar R, Bizzarro T, Fadda G, Adhikari-Guragain D, Hatem J, Larocca LM, Samolczyk J, Slade J, Rossi ED. In 2017, the WHO classification of tumours of the endocrine organs established the criteria for a NIFTP diagnosis. FNA, fine needle aspiration; TBSRTC, The Bethesda System for Reporting…. b Zone of colon metastasis to the NIFTP (HES × 400). The incidences of the 6 diagnostic categories (DCs I-VI) were 14.8%, 17.1%, 15.8%, 2.3%, 11.6% and 38.5%, respectively. JAMA Oncol. Calculate business or professional income, get industry codes, and report various income types. Cho Corresponding Author: Yuri E. Nikiforov, MD, PhD, Department of Pathology, University of Pittsburgh, 3477 Euler Way, Rm 8031, Pittsburgh, PA 15213 (nikiforovye@upmc.edu). Rosario File income tax, get the income tax and benefit package, and check the status of your tax refund. The initially proposed diagnostic criteria for NIFTP allowed for less than 1% papillae.1 However, the intention of the authors was to accept single rudimentary, hyperplastic-type papillae and not true papillae with well-developed nuclear features seen in classic PTC. And while thyroid incidence is still statistically increasing an average of 5.7% per year, based on this NIFTP estimate, more specific codes for NIFTP may result in a further decline in thyroid cancer incidence trends. Noninvasive follicular thyroid neoplasm with papillarylike nuclear features (NIFTP): a new term has been used to describe a type of papillary thyroid cancer which is non-invasive. G, Scognamiglio To eliminate the word “cancer,” the term noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) was introduced. d High mitotic activity, defined as 3 or more mitoses per 10 high-power fields (×400). Such notes can be useful in helping guide surgical management. 2018 Jan;126(1):20-26. doi: 10.1002/cncy.21926. a Thick, thin, or partial capsule or well circumscribed with a clear demarcation from adjacent thyroid parenchyma. Xu Umbricht cautions that the study methodology may have overestimated the incidence of NIFTP, as well as its … In North America, reportablility follows the guidelines established by the WHO. These previous researchers found that NIFTP was benign in a cohort of 109 patients, with no recurrence. nuclear features (NIFTP)is arecently recognizedindolent neo-plasm separated from invasive follicular variant of papillary thyroid carcinoma (FVPTC). Statistical analysis was performed using IBM SPSS Sta-tistics (version 20.0). To avoid misdiagnosing these tumors as NIFTP, we propose to substitute the criterion of “less than 1% papillae” with the criterion of “no well-formed papillae” (Box). See this image and copyright information in PMC. When "NIFTP≠Ca", the sensitivity, specificity, PPV, NPV and accuracy of the TBSRTC were 98.1%, 81.5%, 99.3%, 61.1%, and 97.5%, respectively. mjcampb@ucdavis.edu. FOIA We will be monitoring WHO “blue books” to see if this reclassification … 2017 Nov;27(11):1341-1346. doi: 10.1089/thy.2017.0500. was conducted in our laboratory information system for thyroid surgical pathology resections of noninvasive EFVPTC/NIFTP (henceforth, this category will be referred to as NIFTP), with Afirma gene-expression classifier (GEC) (Veracyte to download free article PDFs, Outcome of large noninvasive follicular thyroid neoplasm with papillary-like nuclear features. Results: We reviewed English-language publications through PubMed (January 24, 2018), using a keyword search for NIFTP. However, 2 other studies reported that 4% to 6% of patients with nodules meeting the diagnostic criteria for NIFTP were found to have metastasis.5,6 Many of these tumors had at least some papillary structures identified, revealed BRAF V600E mutation, and showed metastasis to regional lymph nodes and not distant sites. b Typically nuclear score 2 (moderately expressed nuclear features of papillary thyroid carcinoma). NIFTP allows for a ‘cushion’ between clearly benign and overtly malignant tumors which to some extent eases the diagnostic challenge when encountering an … Thyroid. Clinical safety of renaming encapsulated follicular variant of papillary thyroid carcinoma: is NIFTP truly benign? In tumors with florid nuclear features of papillary … An international group of experts recommended reclassifying non-invasive follicular variant of papillary thyroid cancers (FVPTC) as ‘non-invasive follicular thyroid neoplasm with papillary-like nuclear features’ (NIFTP) in April 2016. Preoperative fine-needle aspiration (FNA) is the cornerstone of surgical planning, but the ability of FNA to distinguish NIFTP from other variants of papillary thyroid … The impact of non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) on the diagnosis of thyroid nodules. Ninety-four cases of encapsulated follicular variant of papillary thyroid carcinoma: a name change to noninvasive follicular thyroid neoplasm with papillary-like nuclear features would help prevent overtreatment. AUS/FLUS ~10-30 6-18 IV. Preoperative fine-needle aspiration (FNA) is the cornerstone of surgical planning, but the ability of FNA to distinguish NIFTP … PW, Mourão All rights reserved. doi:10.1001/jamaoncol.2018.1446. Benign 0-3 no change III. We performed a retrospective study of thyroid fine-needle aspiration (FNA) cases between April 2014 and March 2019. et al. Drafting of the manuscript: Nikiforov, Baloch, Hodak, Seethala, Wenig. Accessibility Statement, Our website uses cookies to enhance your experience. Zhu Y, Ren W, Song Y, Fan Z, Wang Q, Jin H, Guo Y, Bai Y. Gland Surg. The variables were mainly categorical, and the chi-square test was used. The histological features of NIFTP, which are basically those used 2021 American Medical Association. if NIFTP ≠ CA (%) I. ND/UNSAT 5-10 no change II. -, Ibrahim AA, Wu HH Fine-needle aspiration cytology of noninvasive follicular variant of papillary thyroid carcinoma is cytomorphologically distinct from the invasive counterpart. NIFTP is a noninvasive, partially to completely encapsulated thyroid follicular neoplasm arranged in almost exclusively follicular architecture, showing papillary carcinoma-like nuclear features in an adequately sampled … NIFTP is the proposed terminology for neoplasms previously classified as noninvasive encapsulated follicular variant of papillary thyroid carcinoma (PTC), which account for 10 to 20 percent of all diagnoses of PTC. Papillary thyroid microcarcinoma (PTMC) generally is a cancer with excellent prognosis, but the term “cancer” sounds severe and harsh, which can elicit emotional and physical responses from patients. … Thyroid. © 2021 American Medical Association. Privacy Policy| et al. a Actual management may depend on other factors (eg, clinical, sonographic) besides the FNA interpretation. Over the course of 18 months, more than 80 peer-reviewed publications have reported institutional experience with NIFTP. 2016;124:181–7. The FNA results were classified according to TBSRTC. Change in Diagnostic Criteria for Noninvasive Follicular Thyroid Neoplasm With Papillarylike Nuclear Features. Molecular testing for BRAF V600E and other mutations or immunohistochemistry for BRAF V600E is advisable but not required for tumors with nuclear score 3. c Requires microscopic examination of the entire tumor capsule interface. Vuong HG, Tran TTK, Bychkov A, Jung CK, Nakazawa T, Kakudo K, Katoh R, Kondo T. Endocr Pract. Kopczyński J, Suligowska A, Niemyska K, Palyga I, Walczyk A, Gąsior-Perczak D, Kowalik A, Hińcza K, Mężyk R, Góźdź S, Kowalska A. Endokrynol Pol. Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is an encapsulated or clearly delimited, noninvasive neoplasm with a follicular growth pattern and nuclear features of papillary thyroid carcinoma (PTC), but without well-formed papillae or psammoma bodies and without typical findings of the aggressive subtypes of PTC or poorly … We focused on large patient cohorts with tumors meeting the diagnostic criteria for NIFTP. Abbreviations: NIFTP, non-invasive follicular thyroid neoplasm with papillary-like nuclear features; CA, carcinoma; FNA, fine-needle aspiration. NIFTP has rigorous histopathologic diagnostic criteria, including papillary-like nuclear features, and submission of the entire tumor capsule and content is required to exclude both invasion and presence of papillary structures. The variables were mainly categor-ical, and the chi-square test was used. Nomenclature revision for encapsulated follicular variant of papillary thyroid carcinoma: a paradigm shift to reduce overtreatment of indolent tumors. Keywords: BACKGROUND: The newly termed tumor 'noninvasive follicular thyroid neoplasm with papillary-like nuclear features' (NIFTP) acts in an indolent manner and can likely be safely managed with a thyroid lobectomy. doi: 10.1002/cncy.21631. Epub 2019 Mar 7. In the EFVPTC group, 8.1% cytology were hypercellular and the reminder low to moderate cellularity. FNA, fine…, 1. a NIFTP with microfollicular architecture and papillary nuclear features (HES × 400). When "NIFTP=Ca", the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of TBSRTC were 98.0%, 84.0%, 99.4%, 58.3%, and 97.5%, respectively. doi: 10.1089/thy.2017.0500. Cytomorphologic features as predictors of aggressiveness in patients with pT1 papillary thyroid carcinoma: a retrospective study of associations with clinicopathological parameters in 226 fine-needle aspirates. There are 4 variants of papillary thyroid cancer: classic, follicular, tall-cell and noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). Personal, business, corporation, and trust income tax. Flowchart of case screening. Ultrasonography (US), cytology and molecular tests are useful to suspect thyroid nodules that correspond to NIFTP … Thompson For some of the general categories, some degree of subcategorization can be informative and is often appropriate (see Table 1 ). Income tax. Non-invasive follicular thyroid neoplasm with papillarylike nuclear features (NIFTP) is a new name for a very low risk thyroid tumor previously known as an Encapsulated Non-invasive Follicular Variant Papillary Thyroid Carcinoma. Methods: 8600 Rockville Pike Post-surgery histological findings were followed up. All of these features are characteristics of classic papillary thyroid carcinoma (PTC) and are rarely seen in an invasive encapsulated follicular variant of PTC, which is an invasive counterpart of NIFTP. For ex-ample, the tumor has to present encapsulation, purely fol-licular architecture, the presence of nuclear features of papillary thyroid cancer (PTC), and absence of capsular and vascular invasions.
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