Journal of Surgery Concepts & Practice >

2025 , Vol. 30 >Issue 01: 27 - 33

DOI: https://doi.org/10.16139/j.1007-9610.2025.01.06

Consensus and guideline

Interpretation of the 5th edition of WHO classification of endocrine and neuroendocrine tumors: update and progress on follicular cell-derived thyroid tumors

  • LU Shanshan ,
  • JI Yuan
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  • Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China

Received date: 2024-12-10

  Online published: 2025-04-25

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Abstract

The 2022 WHO classification of endocrine and neuroendocrine tumors (5th edition) categorizes thyroid follicular cell-derived tumors into benign, low-risk, and malignant types. Benign tumors now include thyroid follicular nodular lesions. A newly added category previously termed "borderline tumors" have been revised to low-risk follicular cell-derived tumors, which encompass non-invasive follicular thyroid neoplasm with papillary-like nuclear features, thyroid tumors of uncertain malignant potential, and hyalinizing trabecular tumors. The new WHO classification stratifies malignant follicular cell-derived tumors based on molecular characteristics and invasiveness: papillary thyroid carcinoma (PTC) with various histological subtypes represents BRAF-like malignancies; invasive encapsulated follicular variant PTC and follicular thyroid carcinoma represent RAS-like malignancies. Oncocytic carcinoma is now recognized as a distinct entity, specifically referring to tumors composed of ≥75% oncocytic follicular cells lacking PTC nuclear features and high-grade characteristics (necrosis and mitotic figures ≥3/2 mm²). A new category termed "high-grade follicular cell-derived thyroid carcinoma" has been added, encompassing traditional poorly differentiated thyroid carcinoma and differentiated high-grade thyroid carcinoma. Anaplastic thyroid carcinoma(ATC) remains the most undifferentiated type, with thyroid squamous cell carcinoma now classified as a subtype of ATC. The term "papillary thyroid microcarcinoma" is no longer recommended as a distinct subtype. Cribriform-morular thyroid carcinoma is no longer classified as a subtype of PTC, but is instead categorized as a tumor of uncertain histogenesis.

Key words： Thyroid tumor; Thyroid follicular cell; Endocrine and neuroendocrine tumor; Tumor classification; Pathological diagnosis

Cite this article

LU Shanshan , JI Yuan . Interpretation of the 5th edition of WHO classification of endocrine and neuroendocrine tumors: update and progress on follicular cell-derived thyroid tumors[J]. Journal of Surgery Concepts & Practice, 2025 , 30(01) : 27 -33 . DOI: 10.16139/j.1007-9610.2025.01.06

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