PSAMMOMA BODIES IN LYMPH NODES OF THE NECK: POSSIBLE PRECURSOR OF LOCOREGIONAL METASTASES OF PAPILLARY THYROID CARCINOMA
DOI:
https://doi.org/10.15407/exp-oncology.2024.01.061Keywords:
papillary thyroid carcinoma, metastases in locoregional lymph nodes, psammoma bodiesAbstract
Background. Papillary thyroid carcinoma (PTC) is the most common type of well-differentiated thyroid cancer accounting for up to 80% of all thyroid neoplasms. Metastases to the regional lymph nodes (RLN) of the neck are a feature of its biological aggressiveness. The presence of psammoma bodies may be considered a pathomorphological feature of PTC in addition to the papillary structure of tumor and specific nuclear changes. The aim of the study was to evaluate a clinical value of psammoma bodies in the RLN of PTC patients. Materials and Methods. 91 patients with PTC who were surgically treated at the Verum Expert Clinic were enrolled in the study. The clinical and pathomorphological data were retrieved from the archival medical records. Results. According to the results of the clinico-morphological analysis, 51 patients (56%) with PTC had metastases in the RLN of the neck, and 40 (44%) patients had no metastases. Among 51 patients with metastases in the RLN, in 4 patients psammoma bodies in the RLN and tumor tissue were identified. In 3 of these 4 patients, the size of the primary PTC tumor was less than 10 mm, but an aggressive cancer course such as significant number of metastases in the RLN or multifocal growth was found in all these cases. Conclusions. The presence of psammoma bodies in RLN and primary PTC tumor could be suggested as a predictor of metastasis to lymph nodes. The detection of point echogenic foci in the lymph nodes by ultrasound at the preoperative stage is a sign of psammoma bodies. This finding can be useful for improving the efficacy in selection of surgical treatment tactics for the optimal neck dissection by planning neck dissection in the presence of such point echogenic foci at the preoperative stage and performing regular check-ups of the patients.
References
Cherenko SM, Larin OS, Gorobeyko MB, Sichynava RM. Clinical analysis of thyroid cancer in adult patients exposed to ionizing radiation due to the Chernobyl nuclear accident: 5-year comparative investigations based on the results of surgical treatment. World J Surg. 2004;28(11):1071-1074. https://doi.org/10.1007/s00268-004-7561-7
Usenko OY, Khomenko I, Kovalenko AY, et al. Surgical management of thyroid disease. Clinical and practical recommendations. Klin Khir. 2022;89(9-10):41-82. https://doi.org/10.26779/2522-1396.2022.9-10.41 (in Ukrainian).
Guda B, Kovalenko A. Clinico-morphological characteristic of papillary thyroidal carcinomas in patients, born before and after of the Chornobyl AES disaster. Klin Khir. 2019;86(4):29-33. https://doi.org/10.26779/2522-1396.2019.04.29 (in Ukrainian).
Hoperia V, Mostiuk O, Dinets A, et al. New insights into histopathological features of Warthin-like papillary thyroid carcinoma. Int J Endocrinol (Ukraine). 2023;19(6):29-33. https://doi.org/10.22141/2224-0721.19.6.2023.1311.
Min Y, Huang Y, Wei M, et al. Preoperatively predicting the central lymph node metastasis for papillary thyroid cancer patients with Hashimoto's thyroiditis. Front Endocrinol (Lausanne). 2021;12:713475. https://doi.org/10.3389/fendo.2021.713475
Liu C, Xiao C, Chen J, et al. Risk factor analysis for predicting cervical lymph node metastasis in papillary thyroid carcinoma: a study of 966 patients. BMC Cancer. 2019;19(1):622. https://doi.org/10.1186/s12885-019-5835-6
Tong Y, Li J, Huang Y, et al. Ultrasound-based radiomic nomogram for predicting lateral cervical lymph node metastasis in papillary thyroid carcinoma. Acad Radiol. 2021;28(12):1675-1684. https://doi.org/10.1016/j.acra.2020.07.017
Tron'ko M, Zelinskaya G, Kvachenyuk A, et al. Algorithm for predicting of radioiodine resistance of thyroid papillary carcinoma on the basis of cytological study of the material of fine needle aspiration biopsies. Probl Endocrine Pathol. 2019;70(4):96-102. https://doi.org/10.21856/j-PEP.2019.4.13
Cardisciani L, Policardo F, Tralongo P, et al. What psammoma bodies can represent in the thyroid. What we recently learnt from a story of lack of evidence. Pathologica. 2022;114(5):373-375. https://doi.org/10.32074/1591-951X-815
Bai Y, Zhou G, Nakamura M, et al. Survival impact of psammoma body, stromal calcification, and bone formation in papillary thyroid carcinoma. Mod Pathol. 2009;22(7):887-894. https://doi.org/10.1038/modpathol.2009.38
Zancla A, De Santis S, Sotgiu G, et al. Micro-FTIR spectroscopy as robust tool for psammoma bodies detection in papillary thyroid carcinoma. Spectrochim Acta A Mol Biomol Spectrosc. 2020;229:117984. https://doi.org/10.1016/j.saa.2019.117984
Póvoa AA, Teixeira E, Bella-Cueto MR, et al. Clinicopathological features as prognostic predictors of poor outcome in papillary thyroid carcinoma. Cancers (Basel). 2020;12(11):20201029. https://doi.org/10.3390/cancers12113186
Dinets A, Gorobeiko M, Hoperia V, et al. Papillary thyroid carcinoma coexisting with benign thyroid and parathyroid pathology: clinical and pathomorphological features. Int J Endocrinol (Ukraine). 2023;19(4):274-278. https://doi.org/10.22141/2224-0721.19.4.2023.1285
Gorobeiko M, Dinets A. Unexpected mapping of recurrent laryngeal nerve by fluorescence-guided surgery using near-infrared indocyanine green angiography. Int J Endocrinol (Ukraine). 2023;19(5):349-353. https://doi.org/10.22141/2224-0721.19.5.2023.1298
Gorobeiko M, Dinets A. Intraoperative detection of parathyroid glands by autofluorescence identification using image-based system: report of 15 cases. J Med Case Rep. 2021;15(1):414. https://doi.org/ 10.1186/s13256-021-03009-8
Gorobeiko M, Dinets A, Hoperia V, Abdalla K. Improved intraoperative verification of parathyroid glands by determining their autofluorescence in the infrared spectrum. J Endocrinol (Ukraine). 2021;17(6):465-471. https://doi.org/10.22141/2224-0721.17.6.2021.243207
Asya O, Yumuşakhuylu AC, Enver N, et al. A single-center multidisciplinary study analyzing thyroid nodule risk stratification by comparing the thyroid imaging reporting and data system (TI-RADS) and American thyroid association (ATA) risk of malignancy for thyroid nodules. Auris Nasus Larynx. 2023;50(3):410-414. https://doi.org/10.1016/j.anl.2022.08.006
Cibas ES, Ali SZ. The 2017 Bethesda system for reporting thyroid cytopathology. Thyroid. 2017;27(11):1341-1346. https://doi.org/10.1089/thy.2017.0500
Cheren'ko SM, Horobeĭko MA, Vas'ko VV, et al. The choice and substantiation of optimal strategies in the surgical treatment of thyroid cancer. Klin Khir. 2000(8):50-53 (in Russian).
Gorobeiko M, Dinets A, Hoperia V, et al. Papillary microcarcinoma of the thyroid gland: clinical and pathomorphological differences from larger cancers. Endokrynologia. 2023;3(28):231-236. https://doi.org/10.31793/1680-1466.2023.28-3.231.
Gorobeiko M, Dinets A, Pominchuk D, et al. Challenges of differential diagnosis between primary hyperparathyroidism and bone metastases of breast cancer. Clin Med Insights Case Rep. 2022;15:11795476221125136. https://doi.org/10.1177/11795476221125136
Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016;26(1):1-133. https://doi.org/10.1089/thy.2015.0020
Lloyd R, Osamura R, Klöppel G. Other encapsulated follicular-patterned thyroid tumours. Classification of tumours of endocrine organs 4th ed Lyon, France: World Health Organization. 2017:75-80.
Gochhait D, Sreerekha J, Rangarajan V, et al. Cardiac tamponade as an initial presentation of papillary carcinoma with psammoma bodies and intranuclear grooves-A diagnostic dilemma. Diagn Cytopathol. 2019;47(9):927-929. https://doi.org/10.1002/dc.24215
Chernock RD, Lewis JS. Classification of psammoma bodies in the revised college of american pathologists thyroid cancer protocol. Arch Pathol Lab Med. 2015;139(8):967. https://doi.org/ 10.5858/arpa.2014-0483-LE
Kurochkin AV, Moskalenko RA. Diagnostic value of lymph node calcification in thyroid cancer. In: Jankovska A, ed. Theoretical and Practical Aspects of the Development of Modern Scientific Research: Monograph. Riga: Izdevniecība “Baltija Publishing”, 2022:194-212.
Bahcecioglu B, Gursoy A, Ilgan S, et al. What do different echogenic micro-foci in papillary thyroid carcinoma nodules and metastatic lymph nodes represent in histopathology? Endocrine Abstr. 2022;84: PS3-15-141. https://doi.org/10.1530/endoabs.84.PS3-15-141
Luo X, Wang J, Xu M, et al. Risk model and risk stratification to preoperatively predict central lymph node metastasis in papillary thyroid carcinoma. Gland Surg. 2020;9(2):300-310. https://doi.org/10.21037/gs.2020.03.02
Wei X, Wang M, Wang X, et al. Prediction of cervical lymph node metastases in papillary thyroid microcarcinoma by sonographic features of the primary site. Cancer Biol Med. 2019;16(3):587-594. https://doi.org/10.20892/j.issn.2095-3941.2018.0310
Tian X, Song Q, Xie F, et al. Papillary thyroid carcinoma: an ultrasound-based nomogram improves the prediction of lymph node metastases in the central compartment. Eur Radiol. 2020;30(11):5881-5893. https://doi.org/10.1007/s00330-020-06906-6
Carcangiu ML, Zampi G, Pupi A, et al. Papillary carcinoma of the thyroid. A clinicopathologic study of 241 cases treated at the University of Florence, Italy. Cancer. 1985;55(4):805-828. https://doi.org/10.1002/1097-0142(19850215)55:4<805::aid-cncr2820550419>3.0.co;2-z
Gubbiotti MA, Baloch Z, Montone K, Livolsi V. Non-tumoral psammoma bodies correlate with adverse histology in classic type papillary thyroid carcinoma. Arch Otorhinolaryngol Head Neck Surg (AOHNS). 2022;6(1). https://doi.org/10.24983/scitemed.aohns.2022.00156
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