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What is Psammoma bodies in a thyroid lesion or the adjacent metastatic lymph nodes increase the possibility of and explain in detail?
Ans. a (Papillary carcinoma) (Ref. Robbin's pathology 7th ed., 1180)D/d o/Psammoma bodies: Laminated, concentric, calcific spherules seen in:1.Papillary adenocarcinoma of thyroidPapillary (thyroid)2.Serous papillary cystadenocarcinoma of ovarySerous (ovary)3.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