1. Cytopathology of non-invasive follicular thyroid neoplasm with papillary-like nuclear features: A comparative study with similar patterned papillary thyroid carcinoma variants
- Author
-
Deepali Jain, N. Kocheri, Sandeep Mathur, Swati Mahajan, Venkateswaran K. Iyer, and Shipra Agarwal
- Subjects
Adult ,Male ,Pathology ,medicine.medical_specialty ,Histology ,Adolescent ,Cytodiagnosis ,Biopsy, Fine-Needle ,Bethesda system ,030209 endocrinology & metabolism ,medicine.disease_cause ,Pathology and Forensic Medicine ,Thyroid carcinoma ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Cytology ,Adenocarcinoma, Follicular ,Atypia ,medicine ,Humans ,Thyroid Neoplasms ,Child ,Thyroid neoplasm ,Aged ,Aged, 80 and over ,Cell Nucleus ,Suspicious for Malignancy ,medicine.diagnostic_test ,business.industry ,Thyroid ,General Medicine ,Middle Aged ,medicine.disease ,Carcinoma, Papillary ,medicine.anatomical_structure ,Thyroid Cancer, Papillary ,Cytopathology ,Child, Preschool ,030220 oncology & carcinogenesis ,Female ,business - Abstract
OBJECTIVE Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is a recently described, indolent thyroid tumor, with well-defined histopathological diagnostic criteria. Cytology features are not well documented. We reviewed cytology of histologically proven cases of NIFTP and some of its common differentials to look for salient diagnostic features. METHODS Cases reported on histopathology as follicular variant of papillary thyroid carcinoma (FVPTC), or NIFTP between July 2015 and April 2017 having available cytology smears were retrieved and reclassified as NIFTP, FVPTC, and classical papillary thyroid carcinoma with predominant follicular pattern (PTC-FP). Cytological features were assessed, classified as per The Bethesda System for Reporting Cytopathology and compared. RESULTS There were 23 NIFTP cases, 18 FVPTC and 8 PTC-FP. A microfollicle-predominant pattern was seen in all. Nuclear score was 2 in most NIFTP cases (61%). Pseudoinclusions were absent. NIFTP showed features of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) (III) in 61%, follicular neoplasm/suspicious for a follicular neoplasm (FN/SFN) (IV) in 35% and suspicious for malignancy (SFM) (V) in 4%. Most of the FVPTCs were also called FN/SFN (IV) (56%) or AUS/FLUS (III) (22%). Nuclear features did not statistically differ from NIFTP. PTC-FP showed high-grade cytology in 75%, and higher nuclear score (3 in 75%) in contrast to NIFTP (P = .003). CONCLUSION NIFTP and FVPTC show a similar distribution among the Bethesda categories hence precluding conclusive distinction on cytology. PTC-FP, in contrast, was found to have a statistically significant higher nuclear score and more commonly showed malignant cytology.
- Published
- 2018
- Full Text
- View/download PDF