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NIFTP in Western Practice

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Thyroid FNA Cytology

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Abstract

In the not so recent past, the diagnosis of “follicular variant of papillary thyroid carcinoma (FVPC)” especially its encapsulated form has been the center of controversy and debate among experts in endocrine pathology rendering this diagnosis and clinicians managing patients with this thyroid lesion. As we know, FVPC represents a heterogeneous group of carcinomas including both encapsulated (E-FVPCs) and invasive (I-FVPCs) FVPCs; these are not prognostically similar and also do not share molecular profiles.

The Endocrine Pathology Society working group meeting, held at the 2015 USCAP in Boston, questioned whether E-FVPCs should continue to be classified as “carcinoma” and so be treated as such. Based on their multi-institutional histological series and evidence collected by histologic review and long-term follow-up, the endocrine working group recommended the reclassification of E-FVPCs as “noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP).”

This chapter brings forth the key points and summarizes the development and reclassification of E-FVPCs and the adoption of the new terminology “NIFTP” focusing on its current status in diagnostic endocrine pathology, especially in the Western countries. The essential morphological features and the newness based on the application of ancillary techniques are reviewed and discussed in light of new developments.

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Abbreviations

AUS:

Atypia of undetermined significance

BRAF mutation :

v-Raf murine sarcoma viral oncogene homolog B mutation

CNB:

Core needle biopsy

E-FVPC:

Encapsulated follicular variant of papillary thyroid carcinoma

FA:

Follicular adenoma

FLUS:

Follicular lesion of undetermined significance

FN:

Follicular neoplasm

I-FVPC:

Invasive follicular variant of papillary thyroid carcinoma

NIFTP:

Noninvasive follicular thyroid neoplasm with papillary-like nuclear features

PAX8/PPARg :

Paired box transcription factor 8/peroxisome proliferator-activated receptor gamma

PTC:

Papillary thyroid carcinoma

RAS mutation :

rat sarcoma viral oncogene homolog mutation

SM:

Suspicious for malignancy

THADA :

Thyroid-associated adenoma

USCAP:

United States and Canadian Academy of Pathology

WDT-UMP:

Well-differentiated tumor of uncertain malignant potential

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Authors and Affiliations

  1. Division of Anatomic Pathology and Histology, Catholic University of Sacred Heart, Rome, Italy

    Esther Diana Rossi

  2. Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA

    Zubair Baloch

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  1. Esther Diana Rossi
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Correspondence to Esther Diana Rossi .

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  1. Faculty of Medicine, Nara Hospital, Kindai University, Ikoma, Japan

    Kennichi Kakudo

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Rossi, E.D., Baloch, Z. (2019). NIFTP in Western Practice. In: Kakudo, K. (eds) Thyroid FNA Cytology. Springer, Singapore. https://doi.org/10.1007/978-981-13-1897-9_25

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