Seguridad y rendimiento diagnóstico de la medición de PTH en el lavado del aspirado de lesiones sospechosas de adenomas de paratiroides

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.endinu.2020.07.011

Cited by 1 publication

(4 citation statements)

References 31 publications

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“…'s 11 single‐centre prospective study of 179 patients with thyroid pathology, hyperparathyroidism, and undetermined cervical lesions showed specificity and PPV of PTH washout of 100% and 88%, respectively. Comparable results were reported by other groups 12,22 …”

Section: Discussionsupporting

confidence: 85%

“…Comparable results were reported by other groups. 12,22 In our series, as in other studies, 14,16,23 cytology results by themselves were unreliable, as cytologists suspected parathyroid origin in the lesions of only 65% of the patients. This highlights the importance of sending a needle wash sample to PTH washout, following a decision to perform an aspiration.…”

Section: Discussioncontrasting

confidence: 50%

“…A number of studies showed excellent sensitivity (up to 95%) and positive predictive value (PPV, up to 100%) of PTH washout 10–15 ; and provided reassurance regarding the immediate safety of the procedure.…”

Section: Introductionmentioning

confidence: 98%

“…These circumstances include discordant imaging findings, [3][4][5] challenging anatomy (multinodular goiter or concomitant Hashimoto's thyroiditis), [6][7][8] intrathyroid adenoma, 9 and a history of neck surgery. 5 A number of studies showed excellent sensitivity (up to 95%) and positive predictive value (PPV, up to 100%) of PTH washout [10][11][12][13][14][15] ; and provided reassurance regarding the immediate safety of the procedure.…”

mentioning

confidence: 99%

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Parathyroid fine‐needle aspiration with parathyroid hormone washout as a preoperative localisation of parathyroid adenoma—A retrospective study

Klein,

Alsleibi,

Cohen

et al. 2023

Clinical Endocrinology

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Objective: The use of parathyroid lesion aspiration in preoperative adenoma localisation is controversial. Concerns have been raised regarding both immediate safety (hematoma, infection, alterations on a subsequent histologic preparate) and long-term safety (seeding).We aimed to evaluate the short-and long-term safety, and the efficacy, of parathyroid fine-needle aspiration with parathyroid hormone washout as a localisation modality of parathyroid adenoma in patients with primary hyperparathyroidism.Design: A retrospective study. Patients:The sample comprised 29 patients with primary hyperparathyroidism who underwent minimally invasive parathyroidectomy at a tertiary referral centre, following localisation with parathyroid hormone washout. Measurements:We reviewed all parathyroid hormone washout procedures performed during 2011-2021. Clinical, biochemical, and imaging information; and cytology, surgery, and pathology reports were extracted from electronic medical records.Results: Parathyroid hormone levels from the needle wash were 2.1-112.5 times the upper limit of the serum norm. Other than mild neck discomfort, no immediate procedure complications were documented. Fibrotic changes and necrosis were reported in two patients, with no effect on the final pathologic diagnosis or surgery course. No long-term complications (seeding, or parathyromatosis) were found. A total of 26 (90%) patients who were operated following a positive parathyroid hormone washout result were normocalcemic at the end of a mean 38.1-month follow-up period.Conclusions: Parathyroid fine-needle aspiration with parathyroid hormone washout was accurate. Immediate, surgical, or delayed complications were not demonstrated in our series. This approach might be considered for selected patients.

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Section: Discussionsupporting

confidence: 85%