Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-28T13:12:19.419Z Has data issue: false hasContentIssue false
  • English
  • Français

Parathyroid adenomas: pre-operative localization with ultrasound combined with fine-needle biopsy

Published online by Cambridge University Press:  29 June 2007

Tapani Tikkakoski ,
Lars-Eric Stenfors ,
Tapani Typpö ,
Pentti Lohela  and
Meeri Apaja-Sarkkinen
Tapani Tikkakoski*
Affiliation:
Departments of Radiology, Central Hospital of Keski-Pohjanmaa. Kokkola
Lars-Eric Stenfors
Affiliation:
Departments of Otolaryngology. Central Hospital of Keski-Pohjanmaa. Kokkola
Tapani Typpö
Affiliation:
Departments of Radiology, Central Hospital of Keski-Pohjanmaa. Kokkola
Pentti Lohela
Affiliation:
Departments of Radiology, Central Hospital of Keski-Pohjanmaa. Kokkola
Meeri Apaja-Sarkkinen
Affiliation:
The Department of Pathology, Oulu, Finland
*
Tapani Tikkakoski, M.D., Savikukonkuja 3 B, SF-67100 Kokkola, Finland
Get access Rights & Permissions [Opens in a new window]

Abstract

Sixteen patients with biochemically proven primary hyperparathyroidism (PHPT) underwent ultrasonography (US), fine-needle aspiration (FNA) for cytologic sampling (n = 9), or intact parathormone assay (n = 3) before operation (n = 15) in order to determine the accuracy of the methods. Pre-operative US was found sensitive (100 per cent), but two thyroid lesions were initially diagnosed as parathyroid tumours by US (i.e. false positives). Parathyroid cells were detected in six cytologic specimens, one sample was insufficient and another inconclusive, while one was diagnosed as thyroid tissue. Parathormone assay revealed a high hormone content in all three patients who underwent the procedure. We conclude that US is sufficiently sensitive to detect enlarged parathyroid tumours. Specificity can be improved by US-guided FNA for cytology or parathormone assay prior to neck exploration.

Keywords

Parathyroid neoplasmsUltrasonic diagnosisBiopsy, needle
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 107 , Issue 6 , June 1993 , pp. 543 - 545
Copyright
Copyright © JLO (1984) Limited 1993

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Awwad, E., Archer, C., Krebs, F. (1988) Parathyroid adenomas; computed tomographic imaging and the importance of preoperative imaging. Computerized Medical Imaging and Graphics 12: 305–314CrossRefGoogle Scholar
Bergenfelz, A., Forsberg, L., Hederström, E., Ahren, B. (1991) Preoperative localization of enlarged parathyroid glands with ultrasonically guided fine needle aspiration for parathyroid assay. Acta Radiologica 32: 403–405CrossRefGoogle Scholar
Cates, J., Thorsen, K., Lawson, T., Middleton, Wm., Foley, W., Wilson, S., Krubsack, A. (1988) CT evaluation of parathyroid adenomas: diagnostic criteria and pitfalls. Journal of Computer Assisted Tomography 12: 626–629Google Scholar
Doppman, J., Krudy, A., Marx, S., Saxe, A., Scheined, P., Norton, J., Spiegel, A., Downs, R., Schaaf, M., Brennan, M., Schemer, A., Aurbach, G. (1983) Aspiration of enlarged parathyroid glands for parathyroid hormone assay. Radiology 148: 31–35Google Scholar
Foster, G., Bekerman, C., Blend, M., Byrom, E., Pinsky, S. (1989) Preoperative imaging in primary hyperparathyroidism. Archives of Otolaryngology, Head and Neck Surgery 115: 1197–1202Google Scholar
Graif, M., Itzchak, Y., Strauss, S., Dolev, E., Mohr, R., Wolfstein, I. (1987) Parathyroid sonography: diagnostic accuracy related to shape, location and texture of the gland. British Journal of Radiology 60: 439–443Google Scholar
Kairaluoma, M., MäkärSinen, H., Salo-Zetterman, E., Kairaluoma, M., Ståhlberg, M. (1989) Cost effectiveness of ultrasound in primary hyperparathyroidism. British Journal of Surgery 76: 596–597Google Scholar
Karstrup, G., Glenthoj, A., Torp-Pedersen, S., Hegedus, L., Holm, H. (1987) Ultrasonically guided fine needle aspiration of suggested enlarged parathyroid glands. Acta Radiologica 29: 213–216Google Scholar
Karstrup, S., Lohela, P., Apaja-Sarkkinen, M., Borgmästars, H., Holopainen, O. (1988) Non-operative inactivation of a parathyroid tumour in a patient with hypercalcemic crisis. Acta Medica Scandinavia 224: 187–188CrossRefGoogle Scholar
Karstrup, G., Glenthoj, A., Hainau, B., Hegedus, L., Torp-Pedersen, S., Holm, H. (1989 a) Ultrasound-guided, histological, fine-needle biopsy from suspect parathyroid tumours: success-rate and reliability of histological diagnosis. British Journal of Radiology 62: 981–985Google Scholar
Karstrup, S., Transbol, I., HoIm, H., Glenthoj, A., Hegedus, L. (1989 b) Ultrasound-guided chemical parathyroidectomy in patients with primary hyperparathyroidism: a prospective study. British Journal of Radiology 62: 1037–1042Google Scholar
Mäkaräinen, H., Takalo, R., Kairaluoma, M., Salmela, P., Reinilä, M. (1991) Lisäkilpirauhassairauden varmistaminen kaikuohjauksen avulla otetuilla hormooninaytteillä. Duodecim 107: 1613–1618 (in Finnish).Google Scholar
Mincione, G., Borrelli, D., Cicchi, P., Ipponi, P., Fiorini, A. (1986) Fine needle aspiration cytology of parathyroid adenoma. Acta Cytologica 30: 65–69Google Scholar
Randel, S., Gooding, G., Clark, O., Stein, R., Winkler, B. (1987) Parathyroid variants: US evaluation. Radiology 165: 191–194CrossRefGoogle ScholarPubMed
Rastad, J., Johansson, H., Lindgren, P., Ljunghall, S., Stenkvist, B., Åkerström, G. (1984 a). Ultrasonic localization and cytologic identification of parathyroid tumors. World Journal of Surgery 8: 501–508CrossRefGoogle ScholarPubMed
Rastad, J., Fransson, A., Lindgren, P., Johansson, H., Ljunghall, S., Malmaeus, J., Åkerstrom, G. (1984 b) Ultrasonic appearance of adenomatous and hyperplastic parathyroid glands. Acta Radiologica 25: 471–474Google Scholar
Solbiati, L., Montali, G., Croce, F, Bellotti, E, Giangrande, A., Rayetto, C. (1983) Parathyroid tumors detected by fine needle aspiration biopsy under ultrasonic guidance. Radiology 148: 793–797Google Scholar
Spritzer, C., Gefter, W., Hamilton, R., Greenberg, B., Axel, L., Kressel, H. (1987) Abnormal parathyroid glands: High-resolution MR imaging. Radiology 162: 487–491Google Scholar
Uden, P., Aspelin, P., Berglund, J., Lilja, B., Nyman, U., Olsson, L., Zederfeldt, B. (1990) Preoperative localization in unilateral parathyroid surgery. Acta Chir Scand 156: 29–35Google Scholar
Verbanck, J., Clarysse, J., Loncke, R. (1986). Parathyroid aspiration biopsy under ultrasonographic guidance. Archives of Otolaryngology, Head and Neck Surgery 112: 1069–1073Google Scholar