ETA2022 Poster Presentations Nodules & Cancer (10 abstracts)
Follicular thyroid neoplasm with papillary-like nuclear features (NIFT-P) showed peculiar ultrasonographic features compared to follicular variant of papillary thyroid carcinoma (FV-PTC), follicular carcinoma (FTC) and follicular adenoma (FA)
Luigi De Napoli 1 , Antonio Matrone 2 , Carla Gambale 2 , Erica Pieroni 1 , Giulia Boni 1 , Aleksandr Aghababyan 1 , Carlo Enrico Ambrosini 1 , Liborio Torregrossa 3 , Fulvio Basolo 3 , Gabriele Materazzi 1 & Rossella Elisei 2
1Department of Surgical, Medical, Molecular Pathology and Critical Area, Unit of Endocrine Surgery, University Hospital of Pisa; 2Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa; 3Department of Surgical, Medical, Molecular Pathology and Critical Area, University Hospital of Pisa
Background: Up to 2016, NIFT-P was considered a non-invasive encapsulated follicular variant of papillary thyroid carcinoma (FV-PTC) and was reclassified and downgraded to a pre-malignant lesion. However, if these nodules have peculiar ultrasonographic features able to pre-operatively suggest their histology is still a matter of discussion. We evaluated a large series of NIFT-P, FV-PTC, FTC, and FA to characterize their ultrasonographic features.
Methods: We reviewed pre-operative digital ultrasound images and reports of NIFT-P (n = 116), FV-PTC (n = 170), FTC (n = 76), and FA (n = 90) evaluated at the Endocrine Unit of the University Hospital of Pisa, and surgically treated at the Endocrine Surgery Unit of the same hospital. For each nodule we evaluated the following ultrasonographic features: size, composition, echogenicity, shape, margins, and calcifications.
Results: In table 1, the differences in ultrasonographic appearance among the four considered histologies, were highlighted.
| NIFT-P a (n = 116) | FV-PTC b (n = 170) | pa vs b | FTC c (n = 76) | pa vs c | FA d (n = 90) | p a vs d | ||
| Nodule max diameter (cm) | Median (IQR) | 2.1 (1.3-3.7) | 2.3 (1.5-3.7) | 0.27 | 3.1 (1.8-4.4) | <0.01 | 2.7 (1.8-4.4) | <0.01 |
| US features - % | ||||||||
| Composition | Solid Cystic Mixed | 94.8 - 5.2 | 97.1 0.6 2.4 | 0.16 | 96.1 2.6 1.3 | 0.15 | 94.4 3.3 2.2 | 0.10 |
| Echogenicity | Anechoic Hypoechoic Isoechoic Hyperechoic | - 31 63.8 5.2 | 0.6 31.8 61.8 5.9 | 0.85 | 2.6 53.9 40.8 2.6 | <0.01 | 3.3 57.8 36.7 2.2 | <0.01 |
| Margins | Well defined Lobed or irregular | 96.6 3.4 | 84.7 15.3 | <0.01 | 88.2 11.8 | 0.02 | 97.8 2.2 | 0.60 |
| Calcifications | Absent Macro Peripheral Micro Hyperechoic spots | 94 1.7 0.9 2.6 0.9 | 70 9.4 6.5 4.7 9.4 | <0.01 | 76.3 5.3 3.9 9.2 5.3 | 0.01 | 87.8 4.4 1.1 4.4 2.2 | 0.61 |
| Taller than wide | Yes No | 1.7 98.3 | 10 90 | <0.01 | 13.2 86.8 | <0.01 | - 100 | 0.21 |
| Halo | Yes No | 91.4 8.6 | 81.2 18.8 | 0.02 | 69.7 30.3 | <0.01 | 68.9 31.1 | <0.01 |
Conclusion: While FV-PTC and FTC showed significantly more frequent ultrasonographic features suspicious for malignancy; most NIFT-P showed ultrasonographic features suggestive for benignity, similar to FA.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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