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SEER Inquiry System - Report
Produced: 04/05/2025 10:21 PM
Question 20230057
Inquiry Details
References:
#1: WHO Class Endocrine Tumors, 81-91. 5th edition
#2: 2018 EOD Manual. EOD Regional Nodes; see SEER*RSA
Question:
EOD (2018)/EOD Regional Nodes--Thyroid: How is Extent of Disease (EOD) Regional Nodes coded for thyroid primary with cervical lymph nodes containing psammomatous calcifications (psammoma bodies) but negative for metastatic tumor cells? See Discussion.
Discussion:
The AJCC 8th edition confirms that the identification of psammomatous calcifications within a cervical lymph node is metastatic disease.
Example: Patient had a thyroid lobectomy and level VI neck node excision in August 2022. The final diagnosis is multifocal papillary carcinoma of the thyroid, as well as rare psammomatous calcifications only in the resected node. The pathologist notes that “psammoma bodies only” in lymph nodes is not well defined, and while indolent, they do indicate capacity for lymphatic spread and are pN1a.
Should thyroid primaries with cervical node psammomatous calcifications get captured in EOD Regional Nodes category as it is in the AJCC pN staging?
Answer:
Assign EOD Regional Nodes code 300 for Psammoma bodies within a cervical lymph node that are microscopically confirmed. A clarifying note for the Thyroid Schema will be included in the 2025 EOD updates.
