If benign FAs were present in resections containing a malignant diagnosis, they were also tested: 6 FAs were obtained from thyroids with PTCs in the opposite lobe, and 1 was obtained from a patient with a PTC in the same lobe but the opposite pole. That term was often used at our institution for infiltrative follicular variants to eliminate possible confusion with encapsulated follicular variants by treating physicians and/or patients. Two comparison groups were also gathered: 11 benign FAs (also termed adenomatous/adenomatoid nodules by some pathologists because the clonal status of the benign nodules has little diagnostic or clinical import) and 13 cases diagnosed as classic papillary thyroid carcinoma with extensive follicular growth (PTC-EFG). Forty-four cases originally diagnosed as PTC-FV were identified and available.
With institutional review board approval, our institution's diagnostic surgical pathology archives were searched for all cases of papillary thyroid carcinoma follicular variant between 20.
An unencapsulated follicular variant is recognized by the World Health Organization (WHO), which also has a natural history similar to classic PTC 17Ī well-circumscribed type that may be partially or completely encapsulated, is composed almost entirely of follicles, lacks invasion, behaves indolently, and has RAS (but not BRAF V600E) mutations (called the noninvasive encapsulated follicular variant of PTC) 4, 5, 18Īn encapsulated type that is composed almost entirely of follicles and shows capsular, vascular, or intrathyroidal invasion has the capacity for hematogenous metastases and has RAS (but not BRAF V600E) mutations (called the invasive encapsulated follicular variant of PTC). An infiltrative type with sclerotic invasion, at least focal papillae and a behavior similar to classic PTC, with frequent extrathyroidal extension and lymph node metastases, and BRAF V600E (but not RAS) mutations (as described by Chem and Rosai 15 in 1977 and often called the infiltrative follicular variant of PTC).
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