Journal of Korean Endocrine Society 2000;15(4-5):614-621.
Published online January 1, 2001.
A Case of Intrathyroidal Parathyroid Adenoma Diagnosed by Fine-Needle Aspiration.
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
1Department of Internal Medicine, Catholic University College of Medicine, Seoul, Korea.
2Department of Pathology, Catholic University College of Medicine, Seoul, Korea.
Abstract
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.
Key Words: Parathyroid adenoma, Fine-needle aspiration, PTH, Chromogranin


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