- A Case of Intrathyroidal Parathyroid Adenoma Diagnosed by Fine-Needle Aspiration.
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Hye Soo Kim, Eun Kyung Lee, Sung Ha Hwang, Myung Sook Kim, Eun Hee Lee, Jong Min Lee, Suk Young Kim, Bong Yun Cha, Kwang Woo Lee, Ho Young Son, Sung Koo Kang
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J Korean Endocr Soc. 2000;15(4-5):614-621. Published online January 1, 2001
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Abstract
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- Fine-needle aspiration can be successfully utilized in the preoperative localization of abnormal parathyroid tissue. Fine-needle aspirate immunostaining for parathyroid hormone (PTH) or chromogranin and thyroglobulin (Tg) with measurement of PTH and Tg levels in the needle washings (FNAB-PTH and FNAB-Tg) can differentiate an enlarged parathyroid tissue from other cervical masses, such as thyroid nodules and lymph nodes. Parathyroid mass can be successfully aspirated by guidance of ultrasonography or computed tomography. Thyroid nodules are the most frequent cause of reduced accuracy of the imaging studies, such as ultrasonography, computer-assisted tomography and scintigraphy. We report on a case of unsuspected intrathyroidal parathyroid adenoma coexisted with thyroid follicular adenoma presenting two thyroid nodules. After biochemical diagnosis of hyperparathyroidism, we could not localize the parathyroid lesion specifically with any imaging method. Through fine-needle aspiration of two thyroid nodules, we performed the immunostaining for chromogranin and thyroglobulin and the measurement of PTH and thyroglobulin levels in the aspirated materials. The results confirmed the right nodule to be thyroid lesion and the left nodule to be parathyroid lesion preoperatively.
- A Case of Hyperparathyroidism induced from Cystic Parathyroid Adenoma.
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Ki Chul Sung, Kwon Choi, Won Tae Seo, Soon Ho Kwon, Sang Jong Lee, Joo Seob Keum, Myung Sook Kim
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J Korean Endocr Soc. 1997;12(1):75-80. Published online January 1, 2001
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Abstract
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- Cystic parathyroid adenoma is one of the rare causes of hyperparathyroidism, and is usually located in neck and mediastinum. This type of adenoma tends to cause increased serum level of parathyroid hormone and alkaline phosphatase, similar serum calcium level when compared to those of solid adenoma. Thanks to current radioimmunoassay and easy accessibility to serum autoanalyzer, serum calcium level and parathyroid hormone level are more easily measured, which in turn lead to more easier diagnosis of hyperparathyroidism. Also improvement in imaging and nuclear diagnostic method of parathyroid lesion are suggested to enable easy diagnosis of cystic parathyroid adenoma. A 35-year-old male presented with easy fatigability for 12 months. The serum calcium, phosphate, alkaline phosphotase were 11.5mg/dL, 1.4mg/dL, 194IU/L respectively and his parathyroid hormone level in serum was 126.42pg/mL. Neck CT showed enlargement of right lobe of thyroid gland with well defined inhomogenously enhanced density inside the right thyroid gland. The patient was diagnosed of hyperparathyroidim due to parathyroid adenoma and was surgically removed. The surgical biopsy showed cystic parathyroid adenoma. After operation his general condition was improved and serum calcium, phosphate, parathyroid hormone level were normalizd. We report a case of hyperparathyroidism caused by cystic parathyroid adenoma with brief review of literature.
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