Safety and diagnostic performance of parathyroid hormone assay in fine-needle aspirate in suspicious parathyroid adenomas

Carral, Florentino; Jiménez, Ana I.; Tomé, Mariana; Álvarez, José Ángel Expósito; Díez, Ángela Díez; Garcı́a, Concepción; Vega, Vicente Martínez de; Ayala, Carmen

doi:10.1016/j.endien.2020.07.004

Cited by 4 publications

(14 citation statements)

References 31 publications

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“…Following de‐duplication, 319 articles were screened. Nineteen articles fit the inclusion criteria and were included in this review 1,3,4,7,9–23 . Three of these articles were identified through reviewing the references of excluded literature reviews.…”

Section: Resultsmentioning

confidence: 99%

“…Immunostaining of PTH in cells is possible but difficult because only a small amount of PTH is stored in individual chief cells 35,36 . However, finding increased PTH levels in the rinse aspirate obtained via FNA can provide evidence of a parathyroid adenoma, 37 with reported sensitivities ranging from 82% to 94% 11,38,39 . This can be particularly useful in differentiating thyroid nodules from IPAs, which can appear similar on ultrasound 19 …”

Section: Resultsmentioning

confidence: 99%

“…Despite a systematic literature search, data on imaging features of IPAs, especially using modalities such as 4D-CT, 11 C-Met PET/CT, SVS, and MRI are sparse. Further studies using larger sample sizes will be required to determine unique features and to discern sensitivities and specificities.…”

Section: Localization Techniquesmentioning

confidence: 99%

“…35,36 However, finding increased PTH levels in the rinse aspirate obtained via FNA can provide evidence of a parathyroid adenoma, 37 with reported sensitivities ranging from 82% to 94%. 11,38,39 This can be particularly useful in differentiating thyroid nodules from IPAs, which can appear similar on ultrasound. 19 However, FNA has been linked to a high frequency of fibrosis in the parathyroid gland.…”

Section: Ultrasoundmentioning

confidence: 99%

“…The use of multiple localization techniques (e.g., US + sestamibi; US + sestamibi + CT) has been shown to result in a higher accuracy in detecting IPAs than using each technique in isolation. 12,13 Newer nuclear medicine imaging modalities, including 11 C-methionine PET/CT, have been used in localizing parathyroid adenomas. 43,44 11 C-methionine is a critical amino acid in the composition of pre-pro-PTH, the precursor for parathyroid hormone.…”

Section: Nuclear Medicine Imaging Techniques 99mmentioning

confidence: 99%

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Intrathyroidal parathyroid adenomas: Scoping review on clinical presentation, preoperative localization, and surgical treatment

et al. 2022

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Intrathyroidal parathyroid adenomas (IPAs) are a rare cause of primary hyperparathyroidism. They are often difficult to localize preoperatively and intraoperatively, making diagnosis and treatment challenging. Current data on IPAs are sparse and fragmented in the literature. This makes it difficult to compare the effectiveness of different imaging and surgical techniques. To address this issue, this scoping review maps the literature on IPAs, focusing on four domains: clinical presentation, current localization methods, different surgical techniques, and histopathological features. A search of MEDLINE, Embase, and the Cochrane Library was conducted, with 19 studies meeting the inclusion criteria. The characteristics of IPAs on ultrasound, fine‐needle aspiration, CT, MRI, sestamibi‐based techniques, and selective venous sampling are summarized. Emerging imaging modalities, including autofluorescence, are introduced. Surgical methods and intraoperative factors that correlate with high success rates for removal are highlighted. This review also identifies gaps in knowledge to guide further research into this area.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Localization Techniquesmentioning

confidence: 99%

Section: Ultrasoundmentioning

confidence: 99%

Section: Nuclear Medicine Imaging Techniques 99mmentioning

confidence: 99%

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Intrathyroidal parathyroid adenomas: Scoping review on clinical presentation, preoperative localization, and surgical treatment

et al. 2022

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Endocrinology application of molecular imaging: current role of PET/CT

Calderoni,

Giovanella,

Fanti

2024

J Endocrinol Invest

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Background In recent years, nuclear medicine imaging methods have proven to be of paramount importance in a wide variety of diseases, particularly in oncology, where they are crucial for assessing the extent of disease when conventional methods fall short. Moreover, nuclear imaging modalities are able to better characterize lesions using target agents related to specific pathways (e.g. glucose metabolism, cellular proliferation, amino acid transport, lipid metabolism, specific receptor ligands). The clinical presentation of endocrine diseases encompasses a broad spectrum of sign and symptoms. Moreover, endocrine tumors show varying degrees of aggressiveness from well differentiated and indolent to highly aggressive cancers, respectively. Rationale With the application of new medicinal radio-compounds and increasingly advanced tomographic imaging technology, the utility of Positron Emission Tomography/Computed Tomography (PET/CT) in the field of endocrine diseases is expanding. Aim This review aims to analyze and summarize the primary indications of PET/CT, providing a practical approach for clinicians. A comprehensive literature search on PubMed was conducted to provide an updated overview of the available evidence regarding the use of PET/CT in endocrinology. Within this review, we will discuss the applications of PET/CT, compare different radiopharmaceuticals and highlight the uptake mechanism, excluding neuroendocrine carcinomas from discussion. Conclusions PET/CT is a valuable tool in diagnosing and managing endocrine disorders due to its capacity to furnish both functional and anatomical information, facilitate early lesion detection, guide treatment decisions, and monitor treatment response. Its non-invasive nature and precision make it an integral component of modern endocrine healthcare. This review aims to provide physicians with a clear perspective on the role of PET/CT imaging, discussing its emerging opportunities and appropriateness of use in endocrinological diseases.

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Fine needle aspiration biopsy of parathyroid; is it meaningful? A cytologic study of 81 cases with histological and clinical correlations

Bakuła‐Zalewska,

Długosińska,

Stanek‐Widera

et al. 2024

Cytopathology

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BackgroundRecognizing the parathyroid gland and distinguishing the parathyroid from thyroid lesions in fine needle aspiration (FNA) is challenging. This study aimed to identify cytomorphologic features suggestive of parathyroid origin and to assess the utility of cytopathology in conjunction with ancillary tests in the identification of parathyroid glands.Materials and methodsUltrasound (US) guided FNA of parathyroid gland and lesions in 81 patients were reviewed concerning clinical history and correlated to histopathologic findings in available cases. FNA smears were evaluated for cellularity, architectural patterns, cellular and nuclear features, and background of the smears. In 78 cases, FNA was supplemented by a measurement of parathormone (PTH) levels in the needle washout fluid (FNA‐PTH assay) and/or GATA3/PTH/chromogranin‐A immunostainings.ResultsSixty‐four cases were diagnosed cytologically as parathyroid lesions in conjunction with FNA‐PTH assay and/or immunocytochemical examinations. In an additional nine cases, a diagnosis of parathyroid lesions was rendered after repeated FNA with FNA‐PTH assay. The histolopathologic diagnosis of surgically excised cases (n = 75) included parathyroid adenoma (60 cases), atypical parathyroid adenoma (4 cases), parathyroid hyperplasia (10 cases), and parathyroid carcinoma (1 case). Major cytological findings of parathyroid tissue included high cellularity, scattered naked nuclei, cribriform and three‐dimensional clusters, stippled chromatin, and oxyphilic cytoplasm while papillary pattern or colloid‐like material was identified in three cases respectively. No nuclear grooves or inclusions were seen in any case.ConclusionsHigh cellularity scattered naked nuclei, cribriform and three‐dimensional patterns, stippled chromatin and oxyphilic cytoplasm are cytomorphologic features that favour parathyroid origin. A combination of these features with FNA‐PTH assay and/or GATA3, PTH, and chromogranin‐A immunostainings on cytologic specimens aid in the identification of parathyroid glands and the distinguishing of parathyroid from thyroid lesions.

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Safety and diagnostic performance of parathyroid hormone assay in fine-needle aspirate in suspicious parathyroid adenomas

Cited by 4 publications

References 31 publications

Intrathyroidal parathyroid adenomas: Scoping review on clinical presentation, preoperative localization, and surgical treatment

Intrathyroidal parathyroid adenomas: Scoping review on clinical presentation, preoperative localization, and surgical treatment

Endocrinology application of molecular imaging: current role of PET/CT

Fine needle aspiration biopsy of parathyroid; is it meaningful? A cytologic study of 81 cases with histological and clinical correlations

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