Role of fine needle aspiration cytology in diagnosis of brown tumor secondary to parathyroid adenoma

Abstract

Brown tumor (BT) is caused by altered metabolism of calcium resulting from hyperparathyroidism (primary or secondary). The most common cause of hyperparathyroidism is isolated parathyroid adenoma (PA), and the most common symptoms are hypercalcemia related. BT is considered as a late manifestation of PA and usually diagnosed after surgical treatment of the bony lesion. Fine-needle aspiration cytology (FNAC) is a cheap, easy, and less traumatic procedure and should be performed in all lesions wherever possible as unnecessary surgeries may be avoided. We here report a rare case of PA presenting primarily as BT and diagnosed on FNAC.

Gnathic Bones and Hyperparathyroidism: A Review on the Metabolic Bony Changes Affecting the Mandible and Maxilla in case of Hyperparathyroidism

“…The mononuclear cells have scanty ill-defined cytoplasm with irregular margins and monomorphic nuclei. The giant cells are very scanty in number and may vary in size [ 34 ].…”

Cytology of a parietal swelling in a 52‐year‐old man

“…1,2,[6][7][8][9] It is difficult to differentiate those entities based on cytologic features alone and appropriate clinical information such as clinical presentation, site of the lesion, laboratory tests, positive family history and imaging helps to render correct diagnosis. [10][11][12] In the present case, the smears were moderately cellular with a dual population of cells, comprising to the sheets and clusters of mononuclear cells (Figure 2A,C). The corresponding cell block displayed fragments of mononuclear tissue and scattered multinucleated osteoclast-like cells (Figure 3A).…”

“…Other important morphologic mimics, which overlap cytologic features of brown tumours include GCT, ABC, chondroblastoma and cherubism 1,2,6–9 . It is difficult to differentiate those entities based on cytologic features alone and appropriate clinical information such as clinical presentation, site of the lesion, laboratory tests, positive family history and imaging helps to render correct diagnosis 10–12 . In the present case, the smears were moderately cellular with a dual population of cells, comprising mononuclear tumour cells and multinucleated osteoclastic giant cells (Figures 2A–C).…”