Abstract
Simple SummaryNon-invasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTP) are follicular thyroid neoplasm with an indolent clinical behaviour. In this study, we evaluated a retrospective series of 451 NIFTPs, of which 197 (43.7%) presented in coexistence with collateral thyroid tumours. Unifocal and multifocal NIFTPs did not show peculiar ultrasound, cytological, molecular, and histo-pathological characteristics. Considering the high rate of coexisting carcinomas, NIFTP patients might benefit from monitoring of the contralateral lobe.Background: Non-invasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTPs) were introduced in thyroid pathology in 2016. NIFTPs are a group of follicular neoplasm with an indolent behaviour. In this study, we gathered a large retrospective cohort of NIFTPs and compared those presenting as solitary lesions and NIFTPs found in multifocal setting. Methods: A retrospective search of NIFTPs was performed, and the clinico-pathological features were recorded. For a subgroup of patients, pre-surgical ultrasound (US) evaluation, cytological diagnosis, and molecular analysis were available. Results: We collected 451 NIFTPs; 254 (56.3%) were truly solitary tumours, while 197 coexisted with one or more NIFTP/cancer. Contrasting unifocal and multifocal settings, NIFTPs size was the only significantly different parameter. Preoperatively, NIFTP nodules mostly showed low-risk US characteristics, indeterminate cytology and a RAS-like molecular profile. Conclusion: NIFTPs often coexist with collateral thyroid tumours. However, no clinical-pathological differences can be observed between solitary and “multifocal” NIFTPs. Despite the well-established clinical indolence of NIFTP, a careful monitoring of the contralateral lobe should not be excluded.
Highlights
In 186 cases (41.2%), non-invasive follicular thyroid neoplasm with papillary-like features (NIFTP) was in the context of normal parenchyma
NIFTP size was significantly larger in solitary cases (p-value < 0.0001)
Xu and colleagues tried to investigate whether subcentimeter, non-invasive encapsulated follicular variant (NI-EFV) papillary thyroid carcinoma (PTC) could be renamed as NIFTP
Summary
Since 2016, a new histological entity was introduced in the classification of thyroid tumours: non-invasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTPs) made their first appearance in thyroid pathology [1]. It has been demonstrated that these tumours, when no capsular nor vascular invasion is present, have an excellent prognosis after complete resection, even when treated only with lobectomy [8,9] Based on their low-risk molecular profile and indolent biological behaviour, they should be distinguished from infiltrative FVPTCs [5,10]. To reduce clinical overtreatment and psychological consequences associated with a diagnosis of “cancer”, non-invasive encapsulated FVPTCs have been reclassified as NIFTPs [1], with the goal to denote a group of follicular neoplasm with an indolent behaviour [11]. Non-invasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTPs) were introduced in thyroid pathology in 2016. NIFTP nodules mostly showed low-risk US characteristics, indeterminate cytology and a RAS-like molecular profile
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