Noninvasive follicular neoplasm with papillary like nuclear features: A comprehensive analysis with a diagnostic...

Area of Science:

• Endocrinology
• Surgical Pathology
• Diagnostic Cytopathology

Background:

• Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) avoids cancer diagnosis and aggressive treatment.
• Preoperative diagnosis of NIFTP remains challenging, with limited data on its cytological and radiological features.
• Understanding NIFTP's preoperative characteristics is crucial for accurate risk stratification within the Bethesda System.

Purpose of the Study:

• To develop a preoperative diagnostic algorithm for NIFTP.
• To analyze the incidence and preoperative features of NIFTP.
• To assess the impact of NIFTP on the risk of malignancy across Bethesda categories.

Main Methods:

• Retrospective analysis of 20 NIFTP cases.
• Evaluation of cytological and ultrasound (US) features.
• Correlation of NIFTP diagnosis with Bethesda System categories and TIRADS classification.

Main Results:

• NIFTP incidence was higher than reported in other Asian studies.
• TIRADS 3 was the most common sonographic finding for NIFTP.
• NIFTPs were frequently preceded by benign or indeterminate Bethesda categories (II and IV), reducing their malignancy risk by 20% and 27% respectively.

Conclusions:

• Retrospective analyses for NIFTP should include follicular adenoma and adenomatous colloid nodule to determine true incidence.
• NIFTPs typically present with non-malignant preoperative cytology.
• Combined analysis of cytological and ultrasound features, including minor findings, can aid in differentiating NIFTP from similar lesions.