Difference between revisions of "Noninvasive follicular thyroid neoplasm with papillary-like nuclear features"
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==Microscopic== | ==Microscopic== | ||
Features of NIFTP:<ref name=thompson>URL: [http://lesterthompsonmd.com/pdf/2016%20SCPMG%20Thyroid%20NIFTP%20Education%20Module.pdf http://lesterthompsonmd.com/pdf/2016%20SCPMG%20Thyroid%20NIFTP%20Education%20Module.pdf]. Accessed on: 5 April 2016.</ref> | Features of NIFTP:<ref name=thompson>URL: [http://lesterthompsonmd.com/pdf/2016%20SCPMG%20Thyroid%20NIFTP%20Education%20Module.pdf http://lesterthompsonmd.com/pdf/2016%20SCPMG%20Thyroid%20NIFTP%20Education%20Module.pdf]. Accessed on: 5 April 2016.</ref> | ||
*Major features: | *Major features - all required for diagnosis: | ||
**Nuclear features of papillary thyroid carcinoma - 2 or 3 of following: | **Nuclear features of papillary thyroid carcinoma - 2 or 3 of the following: | ||
**#Nuclear membranes changes (irregular membrane contours, nuclear grooves, nuclear pseudoinclusions). | **#Nuclear membranes changes (irregular membrane contours, nuclear grooves, nuclear pseudoinclusions). | ||
**#Size and shape changes (enlargement, elongation, overlapping). | **#Size and shape changes (enlargement, elongation, overlapping). | ||
Line 19: | Line 19: | ||
**Follicular pattern. | **Follicular pattern. | ||
*Minor features: | *Minor features: | ||
**Intratumoural fibrosis, eosinophilic and paucicellular. | **Intratumoural fibrosis, eosinophilic and paucicellular. | ||
**Clefting of follicules from surrounding stroma. | **Clefting of follicules from surrounding stroma. | ||
**Multinucleated cells. | **Multinucleated cells. | ||
**Dark colloid. | |||
Features that exclude the diagnosis of NIFTP:<ref name=thompson/> | Features that exclude the diagnosis of NIFTP:<ref name=thompson/> | ||
*True papillae >1% | *True papillae >1% within the tumour. | ||
*[[Psammoma bodies]]. | *[[Psammoma bodies]]. | ||
*Infiltration of the capsule ''or'' an infiltrative border. | *Infiltration of the capsule ''or'' an infiltrative border. | ||
Line 36: | Line 36: | ||
*[[Papillary thyroid carcinoma]]. | *[[Papillary thyroid carcinoma]]. | ||
*[[Adenomatoid nodule]]. | *[[Adenomatoid nodule]]. | ||
===Images=== | |||
<gallery> | |||
Image:Thyroid NIFTP tumor capsule Thompson 01.tif | NIFTP. (WC/Soca1zim) | |||
Image:Thyroid NIFTP Nuclear Features of nuclear overlapping, crowding and contour irregularities.tif | NIFTP. (WC/Soca1zim) | |||
</gallery> | |||
==See also== | ==See also== |
Latest revision as of 03:33, 12 May 2016
Noninvasive follicular thyroid neoplasm with papillary like-nuclear features is a proposed term for encapsulated thyroid tumours with papillary-like features. It is abbreviated NIFTP[1] and pronounced nift-pee.
The term NIFTP is a compromise of sorts and probably best described as a contrived acronym that can easily be pronounced; NIFTNPLNF isn't catchy or easy to pronounce.
If one wants to make it a backronym, NIFTP could be noninvasive follicular tumour, papillary-like.
General
- Encapsulated thyroid tumours with nuclear papillary-like features without invasion have a good prognosis, and labelling them as cancer is probably not unwarranted.[2]
- Can only be diagnosed on excisional specimens where the entire tumour capsule is sampled.[citation needed]
Microscopic
Features of NIFTP:[3]
- Major features - all required for diagnosis:
- Nuclear features of papillary thyroid carcinoma - 2 or 3 of the following:
- Nuclear membranes changes (irregular membrane contours, nuclear grooves, nuclear pseudoinclusions).
- Size and shape changes (enlargement, elongation, overlapping).
- Chromatin changes (clearing, chromatin margination, glass-like appearance).
- Encapsulated or well-demarcated.
- Follicular pattern.
- Nuclear features of papillary thyroid carcinoma - 2 or 3 of the following:
- Minor features:
- Intratumoural fibrosis, eosinophilic and paucicellular.
- Clefting of follicules from surrounding stroma.
- Multinucleated cells.
- Dark colloid.
Features that exclude the diagnosis of NIFTP:[3]
- True papillae >1% within the tumour.
- Psammoma bodies.
- Infiltration of the capsule or an infiltrative border.
- Lymphovascular invasion.
- Tumour necrosis.
- High mitotic rate (>3/10 HPFs, where HPF undefined - see HPFitis).
DDx:
Images
See also
References
- ↑ URL: http://lesterthompsonmd.com/medical-techniques/2016-scpmg-thyroid-niftp/. Accessed on: 26 March 2016.
- ↑ Ganly, I.; Wang, L.; Tuttle, RM.; Katabi, N.; Ceballos, GA.; Harach, HR.; Ghossein, R. (May 2015). "Invasion rather than nuclear features correlates with outcome in encapsulated follicular tumors: further evidence for the reclassification of the encapsulated papillary thyroid carcinoma follicular variant.". Hum Pathol 46 (5): 657-64. doi:10.1016/j.humpath.2015.01.010. PMID 25721865.
- ↑ 3.0 3.1 URL: http://lesterthompsonmd.com/pdf/2016%20SCPMG%20Thyroid%20NIFTP%20Education%20Module.pdf. Accessed on: 5 April 2016.