Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee.
Department of Pediatric Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
Pediatr Dev Pathol. 2020 Mar-Apr;23(2):121-126. doi: 10.1177/1093526619866584. Epub 2019 Sep 4.
Papillary thyroid carcinoma (PTC) in children has a distinctive set of clinicopathologic features and molecular signature compared to their adult counterparts. The recent recommendation to reclassify encapsulated follicular variant of papillary thyroid carcinoma (EFVPTC) without invasion as noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is based on evidence derived almost exclusively from studies in adults. Clinicopathologic studies restricted to pediatric NIFTP are limited.
We retrospectively analyzed all pediatric PTC and NIFTP diagnosed and treated in our institution from 1999 to 2016 (n = 31).
Using recently published consensus diagnostic criteria, we identified 3 NIFTP and 2 infiltrative follicular variants of papillary thyroid carcinoma (FVPTC) among 31 cases. Two of the NIFTP cases were initially diagnosed as EFVPTC. All 3 patients with NIFTP had unifocal tumors of lower American Joint Committee on Cancer (AJCC) classification (T2 or lower) and were free of lymph node or distant metastasis. Total (n = 1) or completion (n = 2) thyroidectomy was performed in all cases, and only 1 NIFTP patient received subsequent radioablative therapy. No residual or recurrent disease has been observed during follow-up (15-138 months) in patients with NIFTP.
Our experience with NIFTP in children is similar to outcomes reported in adult studies, suggesting that pediatric NIFTP behave indolently as evidenced by the absence of local recurrence in our cohort.
与成人相比，儿童甲状腺乳头状癌（PTC）具有独特的临床病理特征和分子特征。最近建议将无浸润的包膜滤泡型甲状腺乳头状癌（EFVPTC）重新分类为非浸润性滤泡性甲状腺肿瘤伴乳头状核特征（NIFTP），这一建议主要基于几乎完全来自成人研究的证据。专门针对儿科 NIFTP 的临床病理研究有限。
我们回顾性分析了 1999 年至 2016 年在我们机构诊断和治疗的所有儿童 PTC 和 NIFTP（n=31）。
使用最近发布的共识诊断标准，我们在 31 例病例中发现了 3 例 NIFTP 和 2 例浸润性滤泡型甲状腺乳头状癌（FVPTC）。2 例 NIFTP 病例最初诊断为 EFVPTC。所有 3 例 NIFTP 患者的肿瘤均为单一病灶，美国癌症联合委员会（AJCC）分类较低（T2 或更低），且无淋巴结或远处转移。所有病例均行全甲状腺切除术（n=1）或甲状腺次全切除术（n=2），仅 1 例 NIFTP 患者接受了后续放射性治疗。在 NIFTP 患者的随访期间（15-138 个月），未观察到残留或复发疾病。
我们在儿童中对 NIFTP 的经验与成人研究报告的结果相似，这表明儿科 NIFTP 表现出惰性，我们的队列中没有局部复发的证据。
