{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:41:52Z","timestamp":1790613712295,"version":"4.1.0"},"reference-count":48,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2023,5,1]],"date-time":"2023-05-01T00:00:00Z","timestamp":1682899200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Since the noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTPs) was introduced in 2016, most retrospective studies have included cases diagnosed as encapsulated follicular variant of papillary thyroid carcinoma. We investigate a cohort diagnosed with NIFTP at resection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Retrospective institutional cohort of NIFTP from 2016 to 2022, including clinical, cytological, and molecular data for 319 cases (6.6% of thyroid surgeries, 183 cases as NIFTP-only).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The patient cohort had unifocal or multifocal thyroid nodules. Female:male ratio was 2.7:1, mean age was 52 years and median NIFTP size was 2.1\u2009cm. NIFTP was associated with multiple nodules in 23% patients (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200973) and 12% of NIFTP were multifocal (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200939). Fine needle aspiration (FNA) of NIFTP (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009255) were designated as nondiagnostic\u2009=\u20095%, benign\u2009=\u200913%, atypia of undetermined significance\/follicular lesion of undetermined significance (AUS\/FLUS)\u2009=\u200949%, follicular neoplasm\/suspicious for follicular neoplasm (FN\/SFN)\u2009=\u200917%, suspicious for malignancy\u2009=\u200912%, or malignant\u2009=\u20094%. Molecular alterations were identified in 93% (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009114),\n                      <jats:italic toggle=\"yes\">RAS<\/jats:italic>\n                      or\n                      <jats:italic toggle=\"yes\">RAS<\/jats:italic>\n                      -like. Thyroid Imaging Reporting and Data System (TI-RADS) score 4 was recorded in 50% of NIFTP, followed by scores 3 and 5 (26% and 20%, respectively). We also investigated the factors associated with extent of surgery. In our NIFTP-only group (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009183), 66% were identified after hemithyroidectomy (HT) and 34% after total thyroidectomy (TT). On univariate analysis, TT patients demonstrated higher Bethesda category by FNA, more often had aberrant preoperative thyroid function, and\/or underwent an FNA of additional nodule(s). With multivariable regression, Bethesda V NIFTP, in the presence of other nodules being evaluated by FNA and aberrant preoperative thyroid function, independently predicts TT. Bethesda II NIFTP correlated significantly with HT. Fifty-two patients (28%) with NIFTP-only had at least one postoperative surveillance ultrasound. In the NIFTP-only cohort, no HT patients had completion thyroidectomy or received postoperative radioactive iodine. No recurrence or metastases were recorded with median follow-up of 35 months (6\u201376 months;\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009120).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Given this large cohort of NIFTP, including a large subset of isolated NIFTP-only, some with &gt;6 years of follow-up and no tumor recurrences, consensus practical guidelines are needed for adequate postoperative management. Given the American Thyroid Association (ATA) provides guidelines for management of low-risk malignancies, guidance regarding that for borderline\/biologically uncertain tumors, including NIFTP, is a reasonable next step.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/thy.2023.0035","type":"journal-article","created":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T04:43:51Z","timestamp":1679633031000},"page":"566-577","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":21,"title":["A Comprehensive Study on the Diagnosis and Management of Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5628-6384","authenticated-orcid":false,"given":"Bayan A.","family":"Alzumaili","sequence":"first","affiliation":[{"name":"Departments of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren N.","family":"Krumeich","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA."},{"name":"Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2945-5634","authenticated-orcid":false,"given":"Reagan","family":"Collins","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Kravchenko","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emad I.","family":"Ababneh","sequence":"additional","affiliation":[{"name":"Departments of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam S.","family":"Fisch","sequence":"additional","affiliation":[{"name":"Departments of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9043-7171","authenticated-orcid":false,"given":"William C.","family":"Faquin","sequence":"additional","affiliation":[{"name":"Departments of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA."},{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vania","family":"Nos\u00e9","sequence":"additional","affiliation":[{"name":"Departments of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Martinez-Lage","sequence":"additional","affiliation":[{"name":"Departments of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory W.","family":"Randolph","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts, USA."},{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajshri M.","family":"Gartland","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA."},{"name":"Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie C.","family":"Lubitz","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA."},{"name":"Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1036-6367","authenticated-orcid":false,"given":"Peter M.","family":"Sadow","sequence":"additional","affiliation":[{"name":"Departments of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA."},{"name":"Department of Otolaryngology\u2014Head and 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