The impact of psammoma bodies on long-term prognosis in papillary thyroid carcinoma.

INTRODUCTION

Psammoma bodies are characteristic calcified structures of papillary thyroid carcinoma (PTC), but their pathogenesis and prognostic significance remain unclear. This study evaluated their association with clinicopathological features at diagnosis and long-term recurrence in classic PTC.

METHODS

This retrospective study analyzed 102 patients with classic-type PTC followed for a minimum five-year period. Patients were stratified according to psammoma body presence or absence in histopathological specimens.

RESULTS

The cohort included 102 patients (77 female, 25 male) with a mean diagnostic age of 40.4 (± 13.9) years. Psammoma bodies were identified in 66 cases (64.7%). Patients with psammoma bodies were diagnosed at a younger age (p = 0.015). Although psammoma body presence did not differ by gender, the rate of stromal coarse calcification was significantly higher in male patients (36.0%) than in female patients (13.0%) (p = 0.030). On univariable analysis, the prevalence of lymph node metastasis at diagnosis was significantly higher in the psammoma body-positive group (p = 0.001). In multivariable logistic regression analysis, the number of metastatic lymph nodes showed a positive trend toward an association with psammoma body presence, although this did not reach statistical significance (p = 0.078, OR = 1.745, 95% CI: 0.939-3.241). The presence of lymphocytic thyroiditis in non-tumorous thyroid tissue was associated with a reduced incidence of lymph node metastasis (37.1% versus 62.9%). Concerning long-term outcomes, recurrence rates were numerically higher in the psammoma body-positive group without achieving statistical significance (p = 0.532).

CONCLUSION

Psammoma body presence was significantly associated with lymph node metastasis at diagnosis in classic PTC; however, this association was not independently confirmed in multivariable analysis. Psammoma bodies may be associated with nodal disease, but their independent clinical significance remains unclear.