FVPTCFollicular Variant of Papillary Thyroid Carcinoma
FVPTCFollicular Variant of Papillary Thyroid Cancer (genetics)
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14 cases (35%) were of classical PTC, 4 cases (10%) of papillary microcarcinoma, 6 cases (15%) of FVPTC, 1 case (2.5 %) of diffuse sclerosing variant of PTC, 5 cases (12.5%) of FC-MI, one case (2.5%) of FC-WI and 9 cases (22.5%) of cellular nodule.
Bose, "Follicular variant of papillary thyroid carcinoma (FVPTC): histological features, BRAF V600E mutation, and lymph node status," Journal of Cancer Research and Clinical Oncology, 2015.
These histological features are similar to those used formerly to diagnose the noninvasive encapsulated FVPTC, with the study authors proposing a nuclear scoring system with a 94.3% classification accuracy [2].
In 2011, Daniels suggested that it might be possible to reclassify some FVPTCs as benign neoplasms [6].
Occasional cells showed abundant blue cytoplasm with monomorphic round nucleus having pale, powdery chromatin, and nuclear grooves suggestive of FVPTC. Histology showed features of colloid goiter.
FVPTC has follicular architectural pattern with nuclear features of PTC.
This was also done with the follicular-patterned lesions, which constitute a major pathology challenge for diagnosis: CFT, FA, and FVPTC. The comparison of FTC with FA suggested 78.550 as the cutoff point (FTC group greater than or equal to 78.550 and FA less than that), showing a sensitivity of 71.40%, specificity of 78.80%, PPV of 73.14%, NPV of 77.32%, and accuracy of 75.49%.
However, this may due the generic use of the term follicular carcinoma prior to the more recent recognition of specific sub-types, including FVPTC (4).
Papillary thyroid carcinoma and FVPTC have been reported in follicular adenoma, hyperplastic nodules, and Hurthle (oncocytic) cell adenomas.
[3,9] Similar challenges have been encountered with FVPTC due to follicular pattern and paucity of characteristic nuclear features in this entity.
(%) Bethesda III FVPTC 11 (23.9) (AUS/FLUS) Classic PTC 1 (2.2) HCC 1 (2.2) Bethesda IV HCC 1 (2.2) (FN/susp for FN) Bethesda II (benign) None 0 (0) Bethesda V (susp for FVPTC 1 (2.2) malignancy) Bethesda I HCC 1 (2.2) (nondiagnostic) All Categories (b) 16 (34.9) Abbreviations: AUS-FLUS, atypia of undetermined significance- follicular lesion of undetermined significance; FN, follicular neoplasm; FNA, fine-needle aspiration; FVPTC, follicular variant of papillary thyroid carcinoma; HCC, Hurthle cell carcinoma; PTC, papillary thyroid carcinoma;susp, suspicious.
The most frequent histopathological subtypes of PTC are classical variant of PTC (cPTC) and follicular variant of PTC (fvPTC), which are different in histopathology, but they confer similar risk of aggressive outcome, which in case of both tumors is relatively low [5, 6].