Abstract
A consensus panel recently used clinical evidence and pathologic parameters to rename noninvasive encapsulated follicular variant of papillary thyroid carcinoma to noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) to better reflect the indolent course of this tumor. NIFTP has stringent histopathologic diagnostic criteria established by the panel, including papillary-like nuclear features, and submission of the entire tumor capsule to exclude invasion. From a molecular standpoint, NIFTP is often characterized by RAS-type mutations, similar to other follicular-patterned lesions. While there has been prior evidence in the literature for the low malignant potential of these tumors, projects moving forward will help to independently reinforce the reliability of these criteria and nomenclature. With planned inclusion of NIFTP into the latest World Health Organization endocrine tumor classification scheme, this nomenclature shift provides a model for pathology efforts to refine diagnostic classifications to better guide treatment. In this review we discuss this nomenclature change and review the current literature.
Highlights
A group of experts in endocrine neoplasia were led by Dr Nikiforov to formally assess the tumor previously known as “noninvasive encapsulated follicular variant of papillary thyroid carcinoma (FVPTC)” to develop diagnostic criteria and study prognosis
Immunohistochemical stains apart from hematoxylin and eosin are not required for the diagnosis of NIFTP; HBME-1, galectin-3, and CK19 are positive in follicularpatterned tumors which could support a differential diagnosis including NIFTP and EFVPTC [7]
The genetic alterations responsible for NIFTP include RAS oncogene alterations, similar to those driving follicular adenoma and follicular carcinoma tumors, in contrast to the BRAF oncogenes mutated in the classic papillary thyroid cancer pathway [2]
Summary
A group of experts in endocrine neoplasia were led by Dr Nikiforov to formally assess the tumor previously known as “noninvasive encapsulated follicular variant of papillary thyroid carcinoma (FVPTC)” to develop diagnostic criteria and study prognosis. Based on the group’s consensus findings, the new term “noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP)” was announced at the meeting of the Endocrine Pathology Society in March 2015 [1], and the study was published in April 14, 2016, in an online publication of JAMA Oncology [2]. This name change made headlines in the medical community and mainstream media alike [3]. Beyond changing the classification of a small but significant proportion of thyroid cancers, this movement has provided a model for the reclassification of other low grade malignancies
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