Abstract
Since Noninvasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features (NIFTP) was introduced as a new thyroid tumour entity, many studies, and meta-analyses on diagnosing NIFTP have been published. NIFTP-revised histopathological criteria emerged in 2018. NIFTP is defined as a histological entity and its diagnosis requires a careful histological examination. Its molecular profile is similar to follicular-like tumours. Ultrasound features are unable to differentiate NIFTP. NIFTP is not a cytological diagnosis, but it influences the risk of malignancy in several categories of The Bethesda System for Reporting Thyroid Cytopathology terminology.
Highlights
(FAigbubrreev1i.atCiolansss:ifFicVaPtiTonC,offolfloilcluicluarlavr—arpiaanttteornf epdapthilylarroyidthtyurmooidurcsarwciinthompaap; iilElaFrVy-PliTkCe,ninuvclaesairvefeean- ctaupres.u(lAatbebdrefovlilaictiuolnasr:vFaVriPaTnCt,offopllaicpuilllaarryvathriyarnotiodfcpaarcpiinlloamryat;hNyIrFoTidP,cnaorcniinnovmasai;vieEFfoVllPicTuCl,arintvhaysriovied neenocpaplassumlatwedithfopllaipcuilllaarryv–alrikiaennt uocflepaarpfiellaatruyreths)y. roid carcinoma; NIFTP, noninvasive follicular thyroid neoplasm with papillary–like nuclear features)
NIFTP was defined as a “a non-invasive neoplasm of thyroid follicular cells with a follicular growth pattern and nuclear features of papillary thyroid carcinoma (PTC) that has an extremely low malignant potential” in the fourth edition of WHO Classification of Tumours of Endocrine Organs [6]
In 2017, the entity was implemented in a new edition of WHO classification of tumours of endocrine organs and was accepted by the American Thyroid Association [6,7]
Summary
On the ultrasound (US) level, the NIFTP is an oval, well-circumscribed nodule with well detected margins and variable echogenicity, which may be hypoechoic, isoechogenic or heterogeneous [52,53]. A robust multicenter study of 257 thyroid nodules with indeterminate fine needle aspiration cytology, US pattern (based on American Thyroid Association [ATA] and The American College of Radiology Thyroid Image Reporting and Data System [TI-RADS] US risk-stratification systems) and ThyroSeq v3 molecular testing to refine cancer/NIFTP probability in thyroid nodules was recently published. They concluded that no statistically significant advantages for the use of US were found when compared to molecular testing in terms of their discrimination between benign versus cancer/NIFTP cytologically indeterminate nodules [70]. The final diagnosis is based on the histological evaluation of the entire thyroid nodule
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