Non-Invasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features: Emphasizing Diagnostic Reclassification

Authors

Dr. Aniruddh Sinha

Resident, Department of ENT & HNS, Dr. (Brig.) (India)

Dr. Jeevan Galagali

Professor, Department of ENT & HNS, Dr. Cherry Roy, Assistant Professor, Department of ENT & HNS (India)

Dr. Anuja Ghoshal

Senior Resident, Department of ENT & HNS (India)

Dr. Karan Nair

Resident, Department of ENT & HNS (India)

Article Information

DOI: 10.51244/IJRSI.2025.12120101

Subject Category: Health

Volume/Issue: 12/12 | Page No: 1194-1197

Publication Timeline

Submitted: 2025-12-23

Accepted: 2025-12-29

Published: 2026-01-14

Abstract

Non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is a recently recognized thyroid tumour entity with indolent behaviour and extremely low malignant potential, introduced to avoid overdiagnosis and overtreatment of encapsulated follicular variants of papillary thyroid carcinoma (PTC). ¹,² We report a case of an adult male presenting with a solitary thyroid nodule clinically and radiologically suspicious for malignancy. Fine-needle aspiration cytology suggested atypia of undetermined significance – Bethesda category III, whereas USG neck was suggestive of TIRADS 5, prompting surgical intervention. Final histopathological examination revealed the diagnosis of NIFTP. This case highlights the diagnostic difficulty of NIFTP on preoperative fine-needle aspiration cytology and emphasizes the importance of strict histopathological criteria for accurate diagnosis and appropriate treatment.

Keywords

Non-Invasive, Follicular ,Thyroid ,Neoplasm

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References

1. Nikiforov YE, Seethala RR, Tallini G, Baloch ZW, Basolo F, Thompson LDR, Kakudo K, Giordano TJ, Asa SL, Aloisio GM, Fadda G, Hunt JL, Hodak SP, Sadow PM, Cheung CC, Owen RP, Sanchez MA, Leboeuf R, Faquin WC. [Google Scholar] [Crossref]

2. Nomenclature revision for encapsulated follicular variant of papillary thyroid carcinoma: A paradigm shift to reduce overtreatment of indolent tumors. JAMA Oncology. 2016 Aug;2(8):1023–1029. doi:10.1001/jamaoncol.2016.0386. PMID: 27078145. [Google Scholar] [Crossref]

3. Davies L, Welch HG. Increasing incidence of thyroid cancer in the United States, 1973–2002. Journal of the American Medical Association. 2006 May 10;295(18):2164–2167. [Google Scholar] [Crossref]

4. doi:10.1001/jama.295.18.2164. PMID: 16684987. [Google Scholar] [Crossref]

5. Lloyd RV, Osamura RY, Klöppel G, Rosai J, editors. WHO Classification of Tumors of Endocrine Organs. 4th edition. Lyon (France): International Agency for Research on Cancer (IARC); 2017. (IARC WHO Classification of Tumours, Volume 10). ISBN: 978-92-832-4493-6 . [Google Scholar] [Crossref]

6. Nikiforov YE, Seethala RR, Tallini G. Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP): A new diagnostic category in thyroid pathology. Endocrine Pathology. 2018 Mar;29(1):1–6. doi:10.1007/s12022-017-9507-3. PMID: 29243057. [Google Scholar] [Crossref]

7. Howitt BE, Jia Y, Sholl LM, Barletta JA. Molecular alterations in noninvasive follicular thyroid neoplasm with papillary-like nuclear features. Endocrine Pathology. 2015 Jun;26(2):156–162. doi:10.1007/s12022-015-9368-8. PMID: 25899794. [Google Scholar] [Crossref]

8. Rosario PW, Mourão GF, Nunes MB, Barroso AL, Purisch S. Noninvasive follicular thyroid neoplasm with papillary-like nuclear features: ultrasonographic characteristics. Endocrine. 2017 Mar;55(3):789–794. doi:10.1007/s12020-016-1176-2. PMID: 27882487. [Google Scholar] [Crossref]

9. Baloch ZW, LiVolsi VA, Asa SL, Rosai J, Merino MJ, Randolph G, Vielh P, DeMay RM, Sidawy MK, Frable WJ. Diagnostic terminology and morphologic criteria for cytologic diagnosis of thyroid lesions: A synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration State of the Science Conference. Diagnostic Cytopathology. 2008 Jun;36(6):425–437. doi:10.1002/dc.20830. PMID: 18478616. [Google Scholar] [Crossref]

10. Strickland KC, Howitt BE, Barletta JA, Cibas ES, Krane JF. The impact of noninvasive follicular thyroid neoplasm with papillary-like nuclear features on the risk of malignancy in the Bethesda system for reporting thyroid cytopathology. Cancer Cytopathology. 2015 Dec;123(12):713–720. [Google Scholar] [Crossref]

11. doi:10.1002/cncy.21588. PMID: 26481245. [Google Scholar] [Crossref]

12. Thompson LDR. Ninety-four cases of encapsulated follicular variant of papillary thyroid carcinoma: A name change to non invasive follicular thyroid neoplasm with papillary-like nuclear features would help prevent overtreatment. Modern Pathology. 2016 Jul;29(7):698–707. doi:10.1038/modpathol.2016.65. PMID: 27096235. [Google Scholar] [Crossref]

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