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Preoperative Diagnostic Categories of Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features in Thyroid Core Needle Biopsy and Its Impact on Risk of Malignancy

  • Hee Young Na
  • Ji Won Woo
  • Jae Hoon Moon
  • June Young Choi
  • Woo-Jin Jeong
  • Yeo Koon Kim
  • Ji-Young Choe
  • So Yeon ParkEmail author
Article
  • 22 Downloads

Abstract

This study was designed to evaluate the preoperative diagnostic categories of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) using thyroid core needle biopsy (CNB) and to analyze its impact on the risk of malignancy (ROM). A total of 2687 consecutive thyroid CNBs were reviewed retrospectively and classified into six diagnostic categories using a standardized reporting system similar to the Bethesda System for Reporting Thyroid Cytopathology. Diagnostic categories of CNBs were compared with the final surgical diagnoses, and the ROM in each category was calculated both before and after excluding NIFTP from malignancy. Of 946 surgically resected cases, 683 were diagnosed as papillary thyroid carcinoma (PTC), and 32 (4.7% of PTC) were reclassified as NIFTP. The CNB diagnostic categories of NIFTP were as follows: follicular neoplasm in 20 (62.5%; 14, with nuclear atypia), indeterminate lesion in 11 (34.4%), and suspicious for malignancy in one (3.1%). When combined, NIFTP and encapsulated follicular variant of PTC (EFVPTC) were more often categorized as follicular neoplasm compared with other PTC variants including infiltrative FVPTC. Exclusion of NIFTP from malignant diagnosis led to a significant decrease in the ROM in follicular neoplasm with nuclear atypia category. Thus, thyroid CNB enables to differentiate NIFTP/EFVPTC from other PTCs, providing a useful guide for optimal treatment in patients with these tumors.

Keywords

Thyroid Core needle biopsy Encapsulated follicular variant of papillary thyroid carcinoma Noninvasive follicular thyroid neoplasm with papillary-like nuclear features Risk of malignancy 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

This study was approved by the Institutional Review Board (IRB) of the Seoul National University Bundang Hospital (IRB No. B-1812-510-108). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Institutional review board waived the requirement for obtaining informed consent for this study.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of PathologySeoul National University Bundang Hospital, Seoul National University College of MedicineSeongnamRepublic of Korea
  2. 2.Department of Internal MedicineSeoul National University Bundang Hospital, Seoul National University College of MedicineSeongnamRepublic of Korea
  3. 3.Department of SurgerySeoul National University Bundang Hospital, Seoul National University College of MedicineSeongnamRepublic of Korea
  4. 4.Department of Otorhinolaryngology–Head and Neck SurgerySeoul National University Bundang Hospital, Seoul National University College of MedicineSeongnamRepublic of Korea
  5. 5.Department of RadiologySeoul National University Bundang Hospital, Seoul National University College of MedicineSeongnamRepublic of Korea
  6. 6.Department of PathologyHallym University Sacred Heart HospitalAnyangRepublic of Korea

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