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Interobserver and intraobserver variation in the morphological evaluation of noninvasive follicular thyroid neoplasm with papillary‐like nuclear features in Asian practice
Author(s) -
Liu Zhiyan,
Bychkov Andrey,
Jung Chan Kwon,
Hirokawa Mitsuyoshi,
Sui Shaofeng,
Hong SoonWon,
Lai ChiungRu,
Jain Deepali,
Canberk Sule,
Kakudo Kennichi
Publication year - 2019
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/pin.12779
Subject(s) - medicine , thyroid carcinoma , thyroid neoplasm , thyroid , pathology , kappa , radiology , nuclear medicine , linguistics , philosophy
To evaluate the current diagnostic criteria in reporting nuclear features of noninvasive follicular thyroid neoplasm with papillary‐like nuclear features (NIFTP), nine Asian pathologists with expertise in thyroid reviewed virtual slides of 30 noninvasive follicular patterned thyroid lesions according to the nuclear scoring system originally proposed by an international expert and a more detailed scoring system proposed by the Asian Working Group. The interobserver agreement for nuclear grading score was generally moderate (kappa value = 0.452). The best consistency fell on the chromatin features (kappa value = 0.658–1.000). A fair to moderate interobserver agreement was demonstrated in the evaluation of nuclear elongation, nuclear overlapping, membrane irregularities and distribution of papillary thyroid carcinoma (PTC) type nuclear features. A slight agreement was rendered for the evaluation of the nuclear enlargement. Intraobserver agreement was substantial to perfect when comparing results of both scoring systems. However, both scoring systems were not able to reliably separate NIFTP from an encapsulated follicular variant PTC with minimal lymph node metastasis or BRAF V600E mutation. Although the three‐point nuclear scoring system for the diagnosis of NIFTP is widely used in Asian practice, interobserver variation was considerable. Ancillary immunohistochemical or molecular testing might be helpful in differentiating NIFTP from true PTC.