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- Title
Noninvasive follicular thyroid neoplasm with papillary‐like nuclear features: An interobserver study of key cytomorphological features from a large academic medical centre.
- Authors
Brandler, Tamar C.; Cho, Margaret; Wei, Xiao‐Jun; Simms, Anthony; Levine, Pascale; Hernandez, Osvaldo; Oweity, Thaira; Zhou, Fang; Simsir, Aylin; Sun, Wei; Rosen, Lisa
- Abstract
Objective: Because of the indolent nature of noninvasive follicular thyroid neoplasm with papillary‐like nuclear features (NIFTP) and potential requisite for a more conservative treatment, it is crucial to identify features of this entity preoperatively. Our group recently published findings that there are several cytomorphological features that may be used as clues to distinguish NIFTP, papillary thyroid carcinoma (PTC) and follicular adenoma (FA) on fine needle aspiration. Therefore, we aimed to determine the interobserver reproducibility of these findings. Methods: Presurgical fine‐needle aspiration slides from NIFTP (n = 30), classic PTC (n = 30) and FA (n = 30) collected from 1/2013‐8/2016 were reviewed by seven cytopathologists blindly. Presence of selected cytomorphological features was recorded and compared to determine percent agreement and inter‐rater reliability among study cytopathologists using Gwet's AC1 statistics. Results: For all the cytomorphological features, the overall percent agreement amongst the pathologists ranged between 65.1% and 86.8% (Gwet's AC1 0.30‐0.80). There was substantial or almost perfect agreement (Gwet's AC1 > 0.60) in seven cytomorphological features in the classic PTC group, in six features in the NIFTP group and in five features in the FA group. There were no features with poor agreement (Gwet's AC1 < 0.0). Conclusions: The current study supports the reproducibility of our previous findings. The high level of agreement amongst pathologists for these groups, and particularly the NIFTP group, supports the notion that when viewed in combination as a cytological profile, these cytomorphological features may assist the cytopathologist in raising the possibility of NIFTP preoperatively. This can potentially aid clinicians in deciding whether more conservative treatment may be appropriate. Because of the indolent nature and potentially conservative treatment of NIFTP ‐ recently removed from the malignant papillary thyroid carcinoma (PTC) category ‐ identifying features of this entity pre‐operatively is important. The current study supports the authors' previous findings, namely the reproducibility of determining the presence or absence of a panel of cytomorphologic features in FNA cytology of NIFTP cases as compared to PTC and follicular adenoma (FA) cases.
- Subjects
THYROID cancer; CELLULAR pathology; NONINVASIVE diagnostic tests; CALCIFICATION; ULTRASONIC imaging
- Publication
Cytopathology, 2019, Vol 30, Issue 1, p39
- ISSN
0956-5507
- Publication type
Article
- DOI
10.1111/cyt.12632