Noninvasive follicular thyroid neoplasm with papillary-like nuclear features
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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.