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psammoma bodies
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psammoma bodies

i recently had a pap done and my doctors calls to tell me that they found psammoma bodies on the smear. i am set to have a biopsy next week. if they have found these bodies does that flat out mean cancer? is it always malignant? I'm also insulin dependent diabetic...will that also be affected?
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Dear Mandy,

No psammoma bodies does not automatically mean there is a cancer. These are little crystals that can be associated with ovarian cancer. But they can also be present in an old scar such as a placental site.

Here is one excellent review of the issue:

Psammoma bodies in routine pap smears may not herald malignancy - Asymptomatic Women
OB/GYN News,  Dec 1, 2002  
The presence of psammoma bodies in a cervical cytology smear has long been thought to be associated with gynecologic malignancies, but a retrospective review of 400,000 smears collected during routine screening suggests they may be an incidental finding in an asymptomatic population.

Dr. Howard G. Muntz, a gynecologic oncologist at Virginia Mason Medical Center in Seattle, reviewed 9 years' worth of Pap smears in a computerized cytology registry finding 25 evaluable samples that contained psammomatous calcifications, for an incidence of 1 in 16,000. "As gynecologists, we worry about psammoma bodies, because they are frequently associated with ovarian serous papillary carcinomas as well as other ... malignancies," he said at the annual meeting of the Pacific Coast Obstetrical and Gynecological Society.
However, the studies that linked 60% of smears containing psammoma bodies to cancer generally included samples from women with malignant background cytology or abnormal symptoms, he noted.

In asymptomatic women undergoing routine screening in Seattle, psammoma bodies were seen in conjunction with a variety of benign conditions and sometimes seemed to indicate nothing at all, Dr. Muntz said at the meeting, cosponsored by the American College of Obstetricians and Gynecologists.


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