J Korean Soc Endocrinol.  2000 Oct;15(4-5):614-621.

A Case of Intrathyroidal Parathyroid Adenoma Diagnosed by Fine-Needle Aspiration

• Kim HS
• Lee EK
• Hwang SH
• Kim MS
• Lee EH
• Lee JM
• Kim SY
• Cha BY
• Lee KW
• Son HY
• Kang SK

Abstract

Fine-needle aspiration can be successfully utilized in the preoperative localization of abnormal parathyroid tissue. Fine-needle aspirate immunostaining for parathyroid hormone (PTH) or chromogranin and thyroglobulin (Tg) with measurement of PTH and Tg levels in the needle washings (FNAB-PTH and FNAB-Tg) can differentiate an enlarged parathyroid tissue from other cervical masses, such as thyroid nodules and lymph nodes. Parathyroid mass can be successfully aspirated by guidance of ultrasonography or computed tomography. Thyroid nodules are the most frequent cause of reduced accuracy of the imaging studies, such as ultrasonography, computer-assisted tomography and scintigraphy. We report on a case of unsuspected intrathyroidal parathyroid adenoma coexisted with thyroid follicular adenoma presenting two thyroid nodules. After biochemical diagnosis of hyperparathyroidism, we could not localize the parathyroid lesion specifically with any imaging method. Through fine-needle aspiration of two thyroid nodules, we performed the immunostaining for chromogranin and thyroglobulin and the measurement of PTH and thyroglobulin levels in the aspirated materials. The results confirmed the right nodule to be thyroid lesion and the left nodule to be parathyroid lesion preoperatively.

MeSH Terms

Adenoma
Biopsy, Fine-Needle*
Diagnosis
Hyperparathyroidism
Lymph Nodes
Needles
Parathyroid Hormone
Parathyroid Neoplasms*
Radionuclide Imaging
Thyroglobulin
Thyroid Gland
Thyroid Nodule
Ultrasonography
Parathyroid Hormone
Thyroglobulin