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World J Surg (2014) 38:17381742 DOI 10.1007/s00268-014-2460-z
Scattered Psammomatous Calcications around Papillary
Thyroid Carcinoma
Yong Sang Lee Soon Won Hong Hang-Seok Chang
Cheong Soo Park
Published online: 5 February 2014 Socit Internationale de Chirurgie 2014
AbstractBackground Although psammomatous calcication is a characteristic pathologic feature of papillary thyroid carcinoma (PTC), the clinical meaning of histologically determined scattered psammomatous calcications around PTC is unknown.
Objective The aim of this study was to evaluate the clinical signicance of scattered psammomatous calcications around PTC.
Materials and methods Between January 2009 and July 2009, a total of 546 patients who underwent total thyroidectomy for PTC were enrolled. They were classied into two groups: patients with scattered psammomatous calcications and patients without psammomatous calcications. The clinical ndings, preoperative diagnostic ndings, and histopathologic features were compared between the two groups.
Results Scattered psammomatous calcications around PTC were found in 209 patients (38 %), and mostly in younger patients (p = 0.007), those with inltrative tumor margin (p = 0.022), those with capsule invasion (p = 0.013), and those with lymph node metastasis (p \ 0.001). No statistical signicance was found in
gender, tumor size, multiplicity, and coexisting lymphocytic thyroiditis.
Conclusions Although further studies with large-scale, long-term follow-up will be necessary to validate the relationship between scattered psammomatous calcications and prognosis, scattered psammomatous calcication around PTC may have correlations with the aggressiveness of the PTC.
Introduction
Psammomatous calcications, well circumscribed laminated calcications, are found most commonly in papillary thyroid carcinoma (PTC), meningioma, and papillary serous cystadenocarcinoma of the ovary [1]. In PTC, psammomatous calcications are found within the cores of papillae or in tumor stroma, but usually not in neoplastic follicles. Although various theories have been put forth regarding the pathogenesis of psammomatous calcication, its biochemical mechanism is unclear [2]. The association between psammomatous calcication and PTC has been demonstrated by several histologic studies showing that only 0.051.6 % of normal or benign glands have psammomatous calcication, in contrast with 12.061.0 % of PTC [3].
Psammomatous calcication is one of the most important diagnostic criteria of PTC in ne-needle aspiration (FNA) cytology, and the characteristic pathologic features of PTC. However, the clinical signicance of histopatho-logically determined scattered psammomatous calcication in PTC and that around PTC are still unknown.
The aim of this study...