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'''Noninvasive follicular thyroid neoplasm with papillary like-nuclear features''' is a proposed | '''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'''<ref>URL: [http://lesterthompsonmd.com/medical-techniques/2016-scpmg-thyroid-niftp/ http://lesterthompsonmd.com/medical-techniques/2016-scpmg-thyroid-niftp/]. Accessed on: 26 March 2016.</ref> and pronounced ''nift-pee''. | ||
The term ''NIFTP'' is a compromise of sorts and probably best described as a [[Wikipedia:Acronym#Contrived_acronyms|contrived acronym]] that can easily be pronounced; ''NIFTNPLNF'' isn't catchy ''or'' easy to pronounce. | |||
If one wants to make it a [[Wikipedia:Backronym|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.<ref name=pmid25721865>{{Cite journal | last1 = Ganly | first1 = I. | last2 = Wang | first2 = L. | last3 = Tuttle | first3 = RM. | last4 = Katabi | first4 = N. | last5 = Ceballos | first5 = GA. | last6 = Harach | first6 = HR. | last7 = Ghossein | first7 = R. | title = 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. | journal = Hum Pathol | volume = 46 | issue = 5 | pages = 657-64 | month = May | year = 2015 | doi = 10.1016/j.humpath.2015.01.010 | PMID = 25721865 }}</ref> | |||
*Can only be diagnosed on excisional specimens where the entire tumour capsule is sampled.{{fact}} | |||
==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> | |||
*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. | |||
*Minor features: | |||
**Intratumoural fibrosis, eosinophilic and paucicellular. | |||
**Clefting of follicules from surrounding stroma. | |||
**Multinucleated cells. | |||
**Dark colloid. | |||
Features that exclude the diagnosis of NIFTP:<ref name=thompson/> | |||
*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: | |||
*[[Follicular thyroid carcinoma]]. | |||
*[[Papillary thyroid carcinoma]]. | |||
*[[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== | ||
*[[Papillary thyroid carcinoma]]. | *[[Papillary thyroid carcinoma]]. | ||
*[[Papillary thyroid carcinoma follicular variant]]. | |||
==References== | ==References== | ||
{{Reflist|1}} | {{Reflist|1}} | ||
==External links== | |||
*[http://lesterthompsonmd.com/medical-techniques/2016-scpmg-thyroid-niftp/ Thyroid NIFTP (lesterthompsonmd.com)]. | |||
[[Category:Endocrine pathology]] | [[Category:Endocrine pathology]] | ||
[[Category:Diagnosis]] | [[Category:Diagnosis]] |
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