Cytological features of “noninvasive follicular thyroid neoplasm with papillary-like nuclear features” and their correlation with tumor histology

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• 作者：Francesca Maletta ; MD^a ; ^{francesca.maletta@unito.it" class="auth_mail" title="E-mail the corresponding author} ; Federica Massa ; MD^a ; ^{federica.massa@edu.unito.it" class="auth_mail" title="E-mail the corresponding author} ; Liborio Torregrossa ; MD ; PhD^b ; ^{libo.torregrossa@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Eleonora Duregon ; MD ; PhD^c ; ^{eleonora.duregon@unito.it" class="auth_mail" title="E-mail the corresponding author} ; Gian Piero Casadei ; MD^d ; ^{gianpiero.casadei@ausl.bologna.it" class="auth_mail" title="E-mail the corresponding author} ; Fulvio Basolo ; MD^b ; ^{fulvio.basolo@med.unipi.it" class="auth_mail" title="E-mail the corresponding author} ; Giovanni Tallini ; MD^e ; ^{giovanni.tallini@ausl.bologna.it" class="auth_mail" title="E-mail the corresponding author} ; Marco Volante ; MD ; PhD^c ; ^{marco.volante@unito.it" class="auth_mail" title="E-mail the corresponding author} ; Yuri E. Nikiforov ; MD ; PhD^f ; ^{nikiforovye@upmc.edu" class="auth_mail" title="E-mail the corresponding author} ; Mauro Papotti ; MD^a ; ^{mauro.papotti@unito.it" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Thyroid cancer ; Thyroid nodules ; Follicular variant papillary carcinoma ; Encapsulated ; Cytology ; NIFTP
• 刊名：Human Pathology
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：54
• 期：Complete
• 页码：134-142
• 全文大小：1209 K

文摘

Among thyroid papillary carcinomas (PTCs), the follicular variant is the most common and includes encapsulated forms (EFVPTCs). Noninvasive EFVPTCs have very low risk of recurrence or other adverse events and have been recently proposed to be designated as noninvasive follicular thyroid neoplasm with papillary-like nuclear features or NIFTP, thus eliminating the term carcinoma. This proposal is expected to significantly impact the risk of malignancy associated with the currently used diagnostic categories of thyroid cytology. In this study, we analyzed the fine needle aspiration biopsy (FNAB) cytology features of 96 histologically proven NIFTPs and determined how the main nuclear features of NIFTP correlate between cytological and histological samples. Blind review of FNAB cytology from NIFTP nodules yielded the diagnosis of “follicular neoplasm” (Bethesda category IV) in 56% of cases, “suspicious for malignancy” (category V) in 27%, “atypia of undetermined significance/follicular lesion of undetermined significance” (category III) in 15%, and “malignant” (category VI) in 2%. We found good correlation (κ = 0.62) of nuclear features between histological and cytological specimens. NIFTP nuclear features (size, irregularities of contours, and chromatin clearing) were significantly different from those of benign nodules but not from those of invasive EFVPTC. Our data indicate that most of the NIFTP nodules yield an indeterminate cytological diagnosis in FNAB cytology and nuclear features found in cytology samples are reproducibly identified in corresponding histology samples. Because of the overlapping nuclear features with invasive EFVPTC, NIFTP cannot be reliably diagnosed preoperatively but should be listed in differential diagnosis of all indeterminate categories of thyroid cytology.