Abstract
FNAC is of limited value in the preoperative assessment of patients with hyperparathyroidism. Majority FNA of parathyroid lesions is unintended, as intrathyroidal parathyroid adenomas and parathyroid cysts are often mistaken for thyroid lesions. Many investigators have stressed the difficulty in discerning thyroid from parathyroid in FNA smears. However, ultra sound (US)-guided FNA of the parathyroid is helpful in patients with persistent hypercalcemia after failed surgery when the neck anatomy is distorted and in patients with atypical or intrathyroidal parathyroid gland location. US-guided FNA may be also useful to localize parathyroid lesions in recurrent disease and to distinguish abnormal parathyroid glands from lymph nodes.
Keywords
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Erbil Y, Salmaslioglu A, Kabul E, Issever H, Tunaci M, Adalet I, et al. Use of preoperative parathyroid fine-needle aspiration and parathormone assay in the primary hyperparathyroidism with concomitant thyroid nodules. Am J Surg. 2007;193(6):665–71.
Abraham D, Sharma PK, Bentz J, Gault PM, Neumayer L, McClain DA. Utility of ultrasound-guided fine-needle aspiration of parathyroid adenomas for localization before minimally invasive parathyroidectomy. Endocr Pract. 2007;13(4):333–7.
Shi C, Guan H, Qi W, Ji J, Wu J, Yan F, et al. Intrathyroidal parathyroid adenoma: diagnostic pitfalls on fine-needle aspiration: two case reports and literature review. Diagn Cytopathol. 2016;44(11):921–5.
Paker I, Yilmazer D, Yandakci K, Arikok AT, Alper M. Intrathyroidal oncocytic parathyroid adenoma: a diagnostic pitfall on fine-needle aspiration. Diagn Cytopathol. 2010;38(11):833–6.
Domingo RP, Ogden LL, Been LC, Kennedy GC, Traweek ST. Identification of parathyroid tissue in thyroid fine-needle aspiration: a combined approach using cytology, immunohistochemical, and molecular methods. Diagn Cytopathol. 2017;45(6):526–32.
Vaidya A, Gouri M, Sudha HM, Mysorekar V, Balekudura A. Ectopic parathyroid adenoma presenting as a mediastinal mass. J Clin Diagn Res JCDR. 2017;11(5):ED40–ED2.
Vu DH, Erickson RA. Endoscopic ultrasound-guided fine-needle aspiration with aspirate assay to diagnose suspected mediastinal parathyroid adenomas. Endocr Pract. 2010;16(3):437–40.
Noussios G, Anagnostis P, Natsis K. Ectopic parathyroid glands and their anatomical, clinical and surgical implications. Exp Clin Endocrinol Diabetes. 2012;120(10):604–10.
Graff-Baker A, Roman SA, Boffa D, Aslanian H, Sosa JA. Diagnosis of ectopic middle mediastinal parathyroid adenoma using endoscopic ultrasonography-guided fine-needle aspiration with real-time rapid parathyroid hormone assay. J Am Coll Surg. 2009;209(3):e1–4.
Balakrishnan M, George SA, Rajab SH, Francis IM, Kapila K. Cytological challenges in the diagnosis of intrathyroidal parathyroid carcinoma: a case report and review of literature. Diagn Cytopathol. 2018;46(1):47–52.
Cho M, Oweity T, Brandler TC, Fried K, Levine P. Distinguishing parathyroid and thyroid lesions on ultrasound-guided fine-needle aspiration: a correlation of clinical data, ancillary studies, and molecular analysis. Cancer Cytopathol. 2017;125(9):674–82.
Lieu D. Cytopathologist-performed ultrasound-guided fine-needle aspiration of parathyroid lesions. Diagn Cytopathol. 2010;38(5):327–32.
Abati A, Skarulis MC, Shawker T, Solomon D. Ultrasound-guided fine-needle aspiration of parathyroid lesions: a morphological and immunocytochemical approach. Hum Pathol. 1995;26(3):338–43.
Wuertz FG, Kresnik E, Malle P, Hyden M, Lind P, Rogatsch H, et al. Fine-needle aspiration with immunohistochemistry using a modified scrape cell block technique for the diagnosis of thyroid and parathyroid nodules. Acta Cytol. 2016;60(2):118–30.
Trimboli P, D’Aurizio F, Tozzoli R, Giovanella L. Measurement of thyroglobulin, calcitonin, and PTH in FNA washout fluids. Clin Chem Lab Med. 2017;55(7):914–25.
Ozderya A, Temizkan S, Cetin K, Ozugur S, Gul AE, Aydin K. The results of parathyroid hormone assay in parathyroid aspirates in pre-operative localization of parathyroid adenomas for focused parathyroidectomy in patients with negative or suspicious technetium-99m-sestamibi scans. Endocr Pract. 2017;23(9):1101–6.
Fustar Preradovic L, Danic D, Dzodic R. Small nonfunctional parathyroid cysts: single institution experience. Endocr J. 2017;64(2):151–6.
Abdelghani R, Noureldine S, Abbas A, Moroz K, Kandil E. The diagnostic value of parathyroid hormone washout after fine-needle aspiration of suspicious cervical lesions in patients with hyperparathyroidism. Laryngoscope. 2013;123(5):1310–3.
Bancos I, Grant CS, Nadeem S, Stan MN, Reading CC, Sebo TJ, et al. Risks and benefits of parathyroid fine-needle aspiration with parathyroid hormone washout. Endocr Pract. 2012;18(4):441–9.
Owens CL, Rekhtman N, Sokoll L, Ali SZ. Parathyroid hormone assay in fine-needle aspirate is useful in differentiating inadvertently sampled parathyroid tissue from thyroid lesions. Diagn Cytopathol. 2008;36(4):227–31.
Halbauer M, Crepinko I, Tomc Brzac H, Simonovic I. Fine needle aspiration cytology in the preoperative diagnosis of ultrasonically enlarged parathyroid glands. Acta Cytol. 1991;35(6):728–35.
Mincione GP, Borrelli D, Cicchi P, Ipponi PL, Fiorini A. Fine needle aspiration cytology of parathyroid adenoma. A review of seven cases. Acta Cytol. 1986;30(1):65–9.
Tseng FY, Hsiao YL, Chang TC. Ultrasound-guided fine needle aspiration cytology of parathyroid lesions. A review of 72 cases. Acta Cytol. 2002;46(6):1029–36.
Liu F, Gnepp DR, Pisharodi LR. Fine needle aspiration of parathyroid lesions. Acta Cytol. 2004;48(2):133–6.
Odronic SI, Reynolds JP, Chute DJ. Cytologic features of parathyroid fine-needle aspiration on ThinPrep preparations. Cancer Cytopathol. 2014;122(9):678–84.
Dimashkieh H, Krishnamurthy S. Ultrasound guided fine needle aspiration biopsy of parathyroid gland and lesions. CytoJournal. 2006;3:6.
Agarwal C, Kaushal M. Parathyroid lesions: difficult diagnosis on cytology. Diagn Cytopathol. 2016;44(8):704–9.
Absher KJ, Truong LD, Khurana KK, Ramzy I. Parathyroid cytology: avoiding diagnostic pitfalls. Head Neck. 2002;24(2):157–64.
Giorgadze T, Stratton B, Baloch ZW, Livolsi VA. Oncocytic parathyroid adenoma: problem in cytological diagnosis. Diagn Cytopathol. 2004;31(4):276–80.
Papanicolau-Sengos A, Brumund K, Lin G, Hasteh F. Cytologic findings of a clear cell parathyroid lesion. Diagn Cytopathol. 2013;41(8):725–8.
Park GS, Lee SH, Jung SL, Jung CK. Liquid-based cytology in the fine needle aspiration of parathyroid lesions: a comparison study with the conventional smear, ThinPrep, and SurePath. Int J Clin Exp Pathol. 2015;8(10):12160–8.
Agarwal AM, Bentz JS, Hungerford R, Abraham D. Parathyroid fine-needle aspiration cytology in the evaluation of parathyroid adenoma: cytologic findings from 53 patients. Diagn Cytopathol. 2009;37(6):407–10.
Kumari N, Mishra D, Pradhan R, Agarwal A, Krishnani N. Utility of fine-needle aspiration cytology in the identification of parathyroid lesions. J Cytol Indian Acad Cytologists. 2016;33(1):17–21.
Sung S, Saqi A, Margolskee EM, Crapanzano JP. Cytomorphologic features distinguishing Bethesda category IV thyroid lesions from parathyroid. CytoJournal. 2017;14:10.
Wong YP, Sharifah NA, Tan GC, Gill AJ, Ali SZ. Intrathyroidal oxyphilic parathyroid carcinoma: a potential diagnostic caveat in cytology? Diagn Cytopathol. 2016;44(8):688–92.
Rossi ED, Revelli L, Giustozzi E, Straccia P, Stigliano E, Lombardi CP, et al. Large non-functioning parathyroid cysts: our institutional experience of a rare entity and a possible pitfall in thyroid cytology. Cytopathology. 2015;26(2):114–21.
Kaplanoglu V, Kaplanoglu H, Ciliz DS, Duran S. A rare cystic lesion of the neck: parathyroid cyst. BMJ Case Rep. 2013;2013.
Ogo A, Komori K, Nishida K, Hiramatsu S, Sakai Y, Matoba Y, et al. Fluid aspiration identified the primary cyst among multiple cervical cysts in a case of hyperparathyroidism. J Endocrinol Investig. 2010;33(5):360–1.
Shifrin A, LiVolsi V, Shifrin-Douglas S, Zheng M, Erler B, Matulewicz T, et al. Primary and metastatic parathyroid malignancies: a rare or underdiagnosed condition? J Clin Endocrinol Metab. 2015;100(3):E478–81.
Fulciniti F, Pezzullo L, Chiofalo MG, Butera D, Losito NS, Tommaselli AP, et al. Metastatic breast carcinoma to parathyroid adenoma on fine needle cytology sample: report of a case. Diagn Cytopathol. 2011;39(9):681–5.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Bakuła-Zalewska, E. (2019). Head and Neck: Parathyroid. In: Domanski, H. (eds) Atlas of Fine Needle Aspiration Cytology. Springer, Cham. https://doi.org/10.1007/978-3-319-76980-6_6
Download citation
DOI: https://doi.org/10.1007/978-3-319-76980-6_6
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-76979-0
Online ISBN: 978-3-319-76980-6
eBook Packages: MedicineMedicine (R0)