Such information should be sought in order to help clinicians in Singapore counsel their patients more precisely on the implications of their FNA results.
However, little is known in terms of the ROM per TBSRTC in a Singapore patient population and how the introduction of NIFTP may affect the ROM. 7 NIFTPs are known to have a very low recurrence rate (near zero), 8 therefore its diagnosis may reduce the patient’s psychological burden and decrease over-treatment. It is diagnosed on histopathology using strict criteria first proposed by Nikiforov et al. NIFTP is a subgroup of noninvasive/ encapsulated follicular variant papillary thyroid carcinoma (PTC) that can be treated as indolent, perhaps benign, tumours. 5 In 2017, the second edition of TBSRTC 6 was published, in which ROM was revised especially for the indeterminate categories and according to the benignity of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). Using TBSRTC, cytopathologists can report FNAs to the referring physician in terms that are succinct, unambiguous and clinically useful. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC), published in 2009, 5 is a 6-tier system with standardised nomenclature. 4 However, thyroid cytology reports should convey a reproducible risk of malignancy (ROM) in order to facilitate surgical decision making. 1,2 This approach allows risk stratification that can reduce the rate of benign lesion removal by diagnostic lobectomies 3 and its associated postoperative morbidity. The impact of NIFTP on ROM in our institution also appears to be lower than that reported in the Western studies.Īs only 5–10% of thyroid nodules harbour malignancy, fine-needle aspiration (FNA) is important in triaging nodules requiring surgical excision from nodules that may be observed. None had lymph node metastasis at presentation, nor locoregional or distant recurrence.Ĭonclusion: Classifying NIFTP as benign decreased ROM in Bethesda II through VI, but the benignity of NIFTP requires more prospective studies to ascertain.
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One had possible rib metastasis as evidenced by I 131 uptake but remained free of structural or biochemical disease during a follow-up period of 110 months. Eight patients with NIFTP had follow-up of 15 to 110 months. Results: The incidence of NIFTP was 1.2% (10 out of 821).
Possible cases of NIFTP were reviewed for reclassification and the impact of NIFTP on ROM was analysed. Methods: We retrospectively identified 821 thyroid nodules with preoperative FNAC from 788 patients out of 1,279 consecutive thyroidectomies performed between January 2010 and August 2016 in a tertiary general hospital in Singapore.
Introduction: The impact of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) on the risk of malignancy (ROM) in fine-needle aspiration cytology (FNAC) per The Bethesda System for Reporting Thyroid Cytopathology has not been well reported in Singapore.