儿童期具有甲状腺滤泡上皮来源乳头状核特征的非侵袭性滤泡性甲状腺肿瘤。
Noninvasive follicular thyroid neoplasm with papillary-like nuclear features in the pediatric age group.
机构信息
Division of Anatomic Pathology and Histology, "Agostino Gemelli" School of Medicine, Catholic University of the Sacred Heart, Rome, Italy.
Department of Pathology, Loyola University School of Medicine, Maywood, Illinois.
出版信息
Cancer Cytopathol. 2018 Jan;126(1):27-35. doi: 10.1002/cncy.21933. Epub 2017 Oct 12.
BACKGROUND
The most common malignant thyroid neoplasm in children is papillary thyroid carcinoma (PTC). In 2015, the Endocrine Pathology Society introduced the terminology "noninvasive follicular thyroid neoplasm with papillary-like nuclear features" (NIFTP) to replace the noninvasive follicular variant of PTC. The objective of the current study was to evaluate previously diagnosed PTC in the pediatric population, reappraise it for NIFTP, and discuss the impact of NIFTP on the risk of malignancy (ROM) for each The Bethesda System for Reporting Thyroid Cytopathology category in the pediatric population.
METHODS
The electronic databases of both study institutions were searched for all thyroidectomy specimens in patients aged <19 years from June 1, 2001 through June 1, 2016. The patient's age, sex, diagnosis, previous fine-needle aspiration cytology diagnosis, and follow-up were tabulated. Slides for available cases were reviewed and cases qualifying as NIFTP were separated.
RESULTS
The cohort included 101 resected nodules; cytological diagnoses were available for 95 cases. These cases included diagnoses of nondiagnostic (5 cases; 5.2%), benign (21 cases; 22.1%), atypia/follicular lesion of undetermined significance (9 cases; 9.5%), follicular neoplasm/suspicious for follicular neoplasm (FN/SFN) (25 cases; 26.3%), suspicious for malignancy (7 cases; 7.4%), and malignant (28 cases; 29.5%). On the histological follow-up, 50 cases (49.5%) were benign, 49 cases (48.5%) were malignant, and 2 cases (1.9%) were NIFTP. These NIFTP cases originally were diagnosed as FNs on fine-needle aspiration cytology. The average ROM for FNs with and without NIFTPs was 28% and 25%, respectively CONCLUSIONS: According to our rate of 1.9% for NIFTPs on reappraisal for resected nodules, this entity is likely to be less frequent in the pediatric population due to the higher prevalence of PTCs and/or more aggressive variants. NIFTPs do not appear to affect the ROM for The Bethesda System for Reporting Thyroid Cytopathology categories in the pediatric population. However, large-scale studies are necessary to determine whether NIFTPs could affect the pediatric population. Cancer Cytopathol 2018;126:27-35. © 2017 American Cancer Society.
背景
儿童最常见的恶性甲状腺肿瘤是甲状腺乳头状癌（PTC）。2015 年，内分泌病理学学会引入了“具有滤泡状核特征的非浸润性滤泡性甲状腺肿瘤”（NIFTP）这一术语，以替代非浸润性滤泡型 PTC。本研究的目的是评估儿科人群中以前诊断的 PTC，重新评估其是否为 NIFTP，并讨论 NIFTP 对儿科人群中每个甲状腺细胞病理学报告系统（Bethesda 系统）分类的恶性风险（ROM）的影响。
方法
通过两家研究机构的电子数据库搜索 2001 年 6 月 1 日至 2016 年 6 月 1 日期间年龄<19 岁的所有甲状腺切除术标本。记录患者的年龄、性别、诊断、以前的细针抽吸细胞学诊断和随访情况。对可获得的病例进行切片审查，并分离出符合 NIFTP 的病例。
结果
该队列包括 101 个切除结节；95 例有细胞学诊断。这些病例包括诊断为无诊断意义（5 例；5.2%）、良性（21 例；22.1%）、不典型/滤泡性病变意义不明（9 例；9.5%）、滤泡性肿瘤/可疑滤泡性肿瘤（FN/SFN）（25 例；26.3%）、可疑恶性（7 例；7.4%）和恶性（28 例；29.5%）。在组织学随访中，50 例（49.5%）为良性，49 例（48.5%）为恶性，2 例（1.9%）为 NIFTP。这些重新评估为 FN 的 NIFTP 病例最初在细针抽吸细胞学检查中诊断为 FN。FN 有和没有 NIFTP 的平均 ROM 分别为 28%和 25%。
结论
根据我们重新评估切除结节的 1.9%的 NIFTP 发生率，由于 PTC 及/或更具侵袭性的变体更为常见，该实体在儿科人群中可能不太常见。NIFTP 似乎不会影响儿科人群中甲状腺细胞病理学报告系统的 ROM。然而，需要进行大规模研究来确定 NIFTP 是否会影响儿科人群。癌症细胞病理学 2018；126：27-35。©2017 美国癌症协会。
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