What psammoma bodies can represent in the thyroid. What we recently learnt from a story of lack of evidence

Abstract

Summary The detection of psammoma bodies (PBs) in the thyroid gland is commonly associated to classic papillary thyroid carcinoma (PTC) and are frequently encountered in differnt subtypes of PTCs. Nonetheless, the evidence of PBs without a PTC may represent a diagnostic challenge. The general statement is that PBs represent a metastatic finding of PTC either when encountered inside the thyroid parenchyma or in the perithyroidal lymph nodes. The majority of authors assess that in presence of PBs, a search for an occult PTC is strongly encouraged and mandatory, especially if a lobectomy had been performed. In fact, it is not uncommon that a contralateral or ipsilateral tumor, mostly PTC, is found leading to the suggestion that the best recommendation is to submit the entire thyroid tissue. Nonetheless, when a cancer has not been found, the possibility of the rare evenience that PBs are likely to be associated with benign conditions should be considered among the differential diagnosis. Herein a short commentary and review of the literature on PBs detection and its diagnosis, based on our recent experience.

Personalized Management of Malignant and Non-Malignant Ectopic Mediastinal Thyroid: A Proposed 10-Item Algorithm Approach

“…They do not seem to be associated with a malignant pattern in EMTs. This is contrast to the clinical significance of identifying micro-calcifications in papillary thyroid carcinomas at the cervical gland (underlying psammoma bodies) [164][165][166][167]. In EMTs, these traits highlight a long-standing condition or the potential of a further enlargement caused by a local necrosis/hemorrhage rather than a thyroid malignancy in EMTs, but further studies are necessary.…”

Cytomorphological features of ALK‐positive pulmonary adenocarcinoma with abundant psammoma bodies

“…The presence of abundant associated psammoma bodies is a rare histologic feature seen in approximately 7.2% of pulmonary adenocarcinoma cases. Abundant psammoma bodies are commonly observed in various tumors such as papillary carcinomas of the thyroid gland, 1 ovarian serous papillary adenocarcinomas, 2 and mesothelioma and is rarely seen in other tumor types such as pancreatic adenocarcinoma, 3 endometrioid endometrial adenocarcinoma, 4 biphasic renal cell carcinomas, 5 and papillary adenocarcinoma of the stomach, 6 and lung adenocarcinomas 7 . It is important to note that psammoma bodies may be present in other benign and reactive conditions such as mesothelial hyperplasia and endosalpingiosis.…”