Reclassification as NIFTP: a Retrospective Review in a Single Institution with an Emphasis on Workload.
Kevin O'Hare1, E O'Regan2,3, A Khattak4
1Department of Histopathology, St. James Hospital, Dublin, Ireland. kohare@tcd.ie.
Endocrine Pathology
|July 7, 2018
Summary
This study found that a small number of papillary thyroid carcinoma (PTC) cases could be reclassified as non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). Histopathology report review was often sufficient for exclusion, allowing efficient case assessment.
Area of Science:
- Endocrinology
- Oncology
- Pathology
Background:
- Non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is a recently defined thyroid tumor entity.
- Accurate classification of NIFTP is crucial for appropriate patient management and avoiding overtreatment.
Purpose of the Study:
- To determine the reclassification rate of papillary thyroid carcinoma (PTC) to NIFTP over a decade.
- To document the clinical status of reclassified cases.
- To assess the slide review workload required for NIFTP exclusion.
Main Methods:
- Retrospective review of histopathology reports for thyroid resections diagnosed as PTC between 2007 and 2016.
- Identification of potential NIFTP cases based on diagnostic criteria.
- Detailed slide review for cases without external pathology access.
Main Results:
- Out of 545 PTC cases reviewed, 71 were potential NIFTP candidates.
- Five cases (6.9% of potential candidates, 0.9% of total PTC) were reclassified as NIFTP.
- Exclusion of NIFTP was efficiently achieved by reviewing histology reports, identifying key exclusion criteria like lymphovascular or capsular invasion.
Conclusions:
- A small but significant proportion of PTC cases can be reclassified as NIFTP.
- Histopathology report review is an effective method for excluding NIFTP, minimizing the need for extensive slide review.
- Reclassified NIFTP cases showed favorable clinical outcomes, with no recurrent or metastatic disease observed.
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