Endocrine Abstracts

Aim: Papillary thyroid carcinoma (PTC) is a malignancy originating from the follicular epithelium of the thyroid gland. Psammoma bodies (PBs), structures characterized by concentric layers surrounding a calcified focus, are a pathognomonic finding in PTC. The precise mechanism of PB formation, as well as their association with clinical presentation and prognosis, remains an area of active investigation. This study aimed to elucidate the influence of PB presence on histopathological and clinical findings at the time of diagnosis and on recurrence status during long-term follow-up in patients with classical-type PTC.

Method: A cohort of 102 patients diagnosed with classical papillary thyroid carcinoma at the Ankara University Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolic Diseases (2010-2022) was retrospectively analyzed. Inclusion criteria were surgical treatment prior to 2019 and availability of pathology data. Existing pathology specimens were re-evaluated for the presence of psammoma bodies.

Results: A total of 102 patients with classical-type papillary thyroid carcinoma were included (77 female [75.5%], 25 male [24.5%]; mean diagnostic age 40.4 ±13.9 years). Pathology specimen re-examination identified psammoma bodies in 66 patients (64.7%). Patients were grouped according to PB presence for further analysis. No significant intergroup gender differences were observed, however the PB-positive group exhibited a significantly lower mean diagnostic age (P = 0.015). Tumor histopathology, including size, capsular invasion, extrathyroidal extension, and presence of non-tumor lymphocytic thyroiditis or nodular goiter, showed no significant difference between groups. The PB-positive group had a higher incidence of lymph node metastasis at diagnosis (P = 0.001). While the PB-positive group displayed a numerically higher long-term recurrence rate, this difference did not reach statistical significance (P = 0.532).

Conclusion: This study suggests a potential association between psammoma PBs in classical-type papillary thyroid carcinoma and lymph node metastasis at diagnosis. While not statistically significant, a higher recurrence rate was observed in PB-positive patients during long-term follow-up. The presence of psammoma body in patients with papillary thyroid carcinoma may be a guide for central lymph node dissection.

Keywords: papillary thyroid carcinoma, psammoma body