Ultrasound-guided fine needle aspiration cytology of parathyroid lesions: A review of 72 cases
Journal
Acta Cytologica
Journal Volume
46
Journal Issue
6
Pages
1029-1036
Date Issued
2002
Author(s)
Abstract
OBJECTIVE: To elucidate the specific cytomorphologic patterns and diagnostic pitfalls in fine needle aspiration cytology (FNAC) of parathyroid lesions. STUDY DESIGN: Seventy-two cases of surgically excised and pathologically verified hyperparathyroidism (20 cases of parathyroid hyperplasia, 51 of parathyroid adenoma and one of parathyroid carcinoma) received preoperative, ultrasound-guided FNAC examination for enlarged parathyroid glands. The smears were reviewed and analyzed. RESULTS: Parathyroid lesions were diagnosed cytologically in 60 cases (83.3%). The presence of colloidlike substance, macrophages or follicular structures in smears led to six cases (8.3%) being misinterpreted as thyroid lesions. The cellularity of the smears was insufficient for interpretation in six cases (8.3%); however, two of these cases were diagnosed by determination of parathyroid hormone (PTH) levels in the fluid. Parathyroid hyperplasia had more tightly cohesive cell clusters with monomorphism, while parathyroid adenoma had more dispersed or loosely cohesive cells with pleomorphism and anisokaryosis. High PTH concentration in an aspirate was noted in all four cases of cystic lesions. CONCLUSION: FNAC provides valuable information for preoperative diagnosis of parathyroid lesions. Colloidlike substance or macrophages do not exclude the diagnosis. Determination of PTH levels in aspirated fluid is helpful for the diagnosis, especially when the cellularity of the smears is insufficient for interpretation.
SDGs
Other Subjects
adult; aged; article; aspiration biopsy; aspiration cytology; cell ultrastructure; controlled study; differential diagnosis; echography; female; histopathology; human; human tissue; major clinical study; male; parathyroid adenoma; parathyroid carcinoma; parathyroid hyperplasia; preoperative evaluation; priority journal
Publisher
S. Karger AG
Type
journal article