<prompt> Psammoma bodies in a thyroid lesion or the adjacent metastatic lymph nodes increase the possibility ofPapillary carcinomaFollicular carcinomaAnaplastic carcinomaHurthle cell carcinoma  <response>: Ans. a Papillary carcinoma Ref. Robbins pathology 7th ed., 1180Dd oPsammoma bodies: Laminated, concentric, calcific spherules seen in:1.Papillary adenocarcinoma of thyroidPapillary thyroid2.Serous papillary cystadenocarcinoma of ovarySerous ovary3.MeningiomaMeningioma4.Malignant mesotheliomaMesotheliomaEducational Points:Adenomas Follicular adenoma is most common; may cause pressure symptoms, pain and rarely thyrotoxicosis Pathology: usually small, well-encapsulated solitary lesionsPapillary Most common thyroid carcinoma Incidence higher in women Pathology: papillary branching pattern; 40 have tumors containing psammoma bodies Cells with characteristic empty-appearing nuclei are characteristic. Cells obtained by FNAC may characteristically show intranuclear inclusions Spread to local nodes in common; hematogenous spread rare Resection curative in most casesFollicular carcinoma More malignant than papillary cancer Pathology: may be encapsulated, with penetration through the capsule; colloid sparse Local invasion and pressure dysphagia, dyspnea, hoarseness, cough Hematogenous metastasis to lungs or bones commonAnaplastic carcinoma Rapid growing, aggressive with poor prognosis, affects older patients Pathology: tumors usually bulky and invasive with undifferentiated anaplastic cells Clinical: early, widespread metastasis and death within 2 years 