View source for Noninvasive follicular thyroid neoplasm with papillary-like nuclear features

'''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==
*[[Papillary thyroid carcinoma]].
*[[Papillary thyroid carcinoma follicular variant]].

==References==
{{Reflist|1}}

==External links==
*[http://lesterthompsonmd.com/medical-techniques/2016-scpmg-thyroid-niftp/ Thyroid NIFTP (lesterthompsonmd.com)].

[[Category:Endocrine pathology]]
[[Category:Diagnosis]]