Non Invasive Follicular Thyroid Neoplasm with Papillary Like Nuclear Features- A Case Series from Tertiary Care Centre In Wayanad

Abstract

Background
NIFTP is a recently introduced entity in the WHO classification of tumours of endocrine organs. It is a diagnosis made exclusively on histopathological examination of thyroid lesions. However a preoperative suspicion can be made correlating with the ultrasonographic and cytological findings. Most of these cases may be over diagnosed in cytological evaluation as Papillary thyroid carcinoma or as a Follicular variant of Papillary thyroid carcinoma. A thorough histopathological examination of all thyroidectomy specimens is the key to diagnosis of NIFTP and thus we undertook this study.
Methods
A retrospective analysis of thyroidectomy specimens with a histopathological diagnosis of NIFTP was done from May 2022 to May 2024, of two years duration which were received in the Department of Pathology in our Tertiary care centre at Wayanad. The slides were retrieved from the archives and the clinical, radiological and cytology evaluation data was collected from the HIS (Hospital Information System). All 7 cases were compared with their cytology reports. Statistical quantitative analysis was conducted for demographic, ultrasound findings, cytology and histopathological diagnosis. Results were presented as frequency/percentage for categorical variables. Qualitative analysis examined with detailed descriptions of cases.
Results
Of these cases, about 71% were females, most of them above 40 years and ultrasound diagnosis of about 57.1% cases were TIRADS III. Cytological evaluation had 42.8 % cases with Bethesda category II and 28.5% Suspicious for Malignancy.
Conclusion
NIFTP may not be conclusively diagnosed or suspected in a preoperative radiological or cytological evaluation. Histopathologically it may be an incidental finding in a benign multinodular goitre. So surgeons might need to have a high index of suspicion for cases of benign, solitary or multinodular thyroid lesions.