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Psammoma bodies in fine needle aspirate of the thyroid in lymphocytic thyroiditis
Abstract:
Psammoma bodies are concentric, laminated microcalcifications that are regarded as nearly specific markers in the thyroid gland for the presence of papillary carcinoma. While psammoma bodies have been seen rarely in some benign thyroid diseases, there appear to be no reports of psammoma body formation in lymphocytic or Hashimoto's thyroiditis. We report a case of Hashimoto's thyroiditis in which psammoma bodies were identified in a fine needle aspiration specimen of the thyroid and in histologic sections of the right thyroid lobectomy; papillary carcinoma was not found in either specimen. We conclude that psammoma bodies may be seen in any benign process, such as nodular goiter or lymphocytic thyroiditis, that produces reactive papillary hyperplasia of thyroid epithelium, as well as in papillary carcinoma. However, the finding of psammoma bodies in a fine needle aspirate without corroborating cytologic evidence of papillary cancer is still an indication for surgical removal of the thyroid nodule since these structures are reliable markers for occult papillary carcinoma of the thyroid, despite the rarity of their formation in benign diseases.
Insights
Psammoma bodies, typically linked to papillary thyroid cancer, were found in a case of Hashimoto's thyroiditis. This suggests they can occur in benign thyroid conditions, necessitating further investigation.
Area of Science:
- Endocrinology
- Pathology
- Oncology
Background:
- Psammoma bodies are microcalcifications often associated with papillary thyroid carcinoma.
- Previous literature indicated their rarity in benign thyroid diseases, with no reports in Hashimoto's thyroiditis.
Observation:
- A case of Hashimoto's thyroiditis presented with psammoma bodies in fine needle aspiration and surgical specimens.
- Papillary carcinoma was notably absent in both diagnostic evaluations.
Findings:
- Psammoma bodies can form in benign thyroid conditions, including Hashimoto's thyroiditis and nodular goiter, particularly with reactive papillary hyperplasia.
- Their presence indicates a potential for occult papillary thyroid carcinoma, even in the absence of clear cytologic evidence.
Implications:
- The findings expand the differential diagnosis for psammoma bodies in thyroid specimens.
- The presence of psammoma bodies, regardless of benign cytologic findings, warrants surgical consideration due to their association with malignancy.