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Non–Tumor-Associated Psammoma Bodies in the Thyroid

Jennifer L. Hunt MD, E. Leon Barnes MD
DOI: http://dx.doi.org/10.1309/RWPPYCBYT2JVA023 90-94 First published online: 1 January 2003

Abstract

Psammoma bodies in the thyroid are common in glands with papillary thyroid carcinoma. Psammoma bodies that are not associated with tumor cells, however, represent a diagnostic problem for pathologists. Should we treat isolated psammoma bodies as representing metastatic disease?

This study included patients who had non–tumor-associated psammoma bodies in their thyroids or in the perithyroidal lymph nodes. Clinical, pathologic, and follow-up information was obtained for the patients. Our results indicate that 27 of 29 patients had a contralateral or an ipsilateral tumor, the majority of which were papillary. We noted a high frequency of microscopic carcinomas (12/27) and of tall cell variants of papillary thyroid carcinoma (8/27 cases).

Based on these findings, we recommend that thyroid glands with non–tumor-associated psammoma bodies and no histologically identified carcinoma be entirely submitted to identify any microscopic carcinoma. If no carcinoma is identified in a lobectomy, discussion with the surgeon should indicate the need for close clinical follow-up.

Key Words:
  • Psammoma body
  • Thyroid
  • Papillary carcinoma
  • Metastasis