Fine-needle aspiration of parathyroid adenomas: Indications as a diagnostic approach.
GATA-3
cytology
fine-needle aspiration
parathyroid adenoma
parathyroid hormone
Journal
Diagnostic cytopathology
ISSN: 1097-0339
Titre abrégé: Diagn Cytopathol
Pays: United States
ID NLM: 8506895
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
16
06
2020
revised:
02
08
2020
accepted:
06
08
2020
pubmed:
25
8
2020
medline:
1
10
2021
entrez:
25
8
2020
Statut:
ppublish
Résumé
We aimed to determine the indication of fine-needle aspiration (FNA) for parathyroid adenoma (PA)-suspected nodules and the cytological features of PA, and to discuss the ancillary techniques for diagnostic confirmation. Clinical, cytological, and histological examinations of 15 PA patients (4.0% of all PA resected patients) were conducted through FNA on 16 nodules. We also examined the cytological preparations of 10 follicular neoplasms (FNs) and 10 poorly differentiated thyroid carcinomas (PDTCs). FNA was performed to detect PA in nine (56.3%) nodules. The remaining seven (43.8%) nodules underwent FNA for lesions considered as thyroid nodules or lymph nodes. The levels of parathyroid hormone (PTH) in the aspiration needle washout fluid were observably high, except for that from one nodule with unsatisfactory FNA. Cytologically, the incidences of wedge pattern (86.7%) and salt and pepper chromatin (86.7%) in PAs were significantly higher than in FNs and PDTCs. In contrast, the appearance of colloid globules and nuclear grooves was less frequent than that of FNs and PDTCs. GATA-3 expression was intense in all PAs that immunocytochemistry were performed. Histologically, capsular invasion and/or laceration, tumor seeding, granulation tissue, and fibrosis were observed. When PA localization is unusual or inconclusive despite extensive imaging, FNA may be performed. We asserted that wedge pattern, salt and pepper chromatin, and the absence of colloid globules and nuclear grooves are diagnostic cytological indicators of PA rather than of FN or PDTC. We recommend PTH measurements using needle washout fluid for PA-suspected nodules, and immunocytochemistry with the GATA-3 antibody for cytologically PA-suspected nodules.
Sections du résumé
BACKGROUND
BACKGROUND
We aimed to determine the indication of fine-needle aspiration (FNA) for parathyroid adenoma (PA)-suspected nodules and the cytological features of PA, and to discuss the ancillary techniques for diagnostic confirmation.
METHOD
METHODS
Clinical, cytological, and histological examinations of 15 PA patients (4.0% of all PA resected patients) were conducted through FNA on 16 nodules. We also examined the cytological preparations of 10 follicular neoplasms (FNs) and 10 poorly differentiated thyroid carcinomas (PDTCs).
RESULTS
RESULTS
FNA was performed to detect PA in nine (56.3%) nodules. The remaining seven (43.8%) nodules underwent FNA for lesions considered as thyroid nodules or lymph nodes. The levels of parathyroid hormone (PTH) in the aspiration needle washout fluid were observably high, except for that from one nodule with unsatisfactory FNA. Cytologically, the incidences of wedge pattern (86.7%) and salt and pepper chromatin (86.7%) in PAs were significantly higher than in FNs and PDTCs. In contrast, the appearance of colloid globules and nuclear grooves was less frequent than that of FNs and PDTCs. GATA-3 expression was intense in all PAs that immunocytochemistry were performed. Histologically, capsular invasion and/or laceration, tumor seeding, granulation tissue, and fibrosis were observed.
CONCLUSIONS
CONCLUSIONS
When PA localization is unusual or inconclusive despite extensive imaging, FNA may be performed. We asserted that wedge pattern, salt and pepper chromatin, and the absence of colloid globules and nuclear grooves are diagnostic cytological indicators of PA rather than of FN or PDTC. We recommend PTH measurements using needle washout fluid for PA-suspected nodules, and immunocytochemistry with the GATA-3 antibody for cytologically PA-suspected nodules.
Identifiants
pubmed: 32833315
doi: 10.1002/dc.24595
pmc: PMC7754293
doi:
Substances chimiques
Parathyroid Hormone
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
70-76Informations de copyright
© 2020 The Authors. Diagnostic Cytopathology published by Wiley Periodicals LLC.
Références
Diagn Cytopathol. 2010 May;38(5):327-32
pubmed: 19845029
Jpn J Clin Oncol. 2004 Mar;34(3):155-8
pubmed: 15078912
Am J Clin Pathol. 1999 Sep;112(3):311-6
pubmed: 10478135
Acta Cytol. 1984 Jul-Aug;28(4):443-9
pubmed: 6589924
Cancer Cytopathol. 2017 Sep;125(9):674-682
pubmed: 28621914
Surgery. 2005 Dec;138(6):1143-50; discussion 1150-1
pubmed: 16360402
Langenbecks Arch Surg. 2006 Nov;391(6):623-6
pubmed: 17021789
Endocr Pract. 2012 Jul-Aug;18(4):441-9
pubmed: 22784830
Case Rep Surg. 2015;2015:243527
pubmed: 26064758
Endocr J. 2016 Jul 30;63(7):621-6
pubmed: 27097544
Korean J Radiol. 2014 Mar-Apr;15(2):267-76
pubmed: 24642650
J Otolaryngol Head Neck Surg. 2017 Jan 7;46(1):4
pubmed: 28061891
J Cytol. 2016 Jan-Mar;33(1):17-21
pubmed: 27011436
Diagn Cytopathol. 2021 Jan;49(1):70-76
pubmed: 32833315
Cytojournal. 2006 Mar 28;3:6
pubmed: 16569241
Curr Treat Options Oncol. 2012 Mar;13(1):11-23
pubmed: 22327883
JAMA Surg. 2016 Oct 1;151(10):959-968
pubmed: 27532368
Coll Antropol. 2010 Mar;34(1):25-9
pubmed: 20432729
Head Neck. 2002 Feb;24(2):157-64
pubmed: 11891946
Endocr Pract. 2007 Jul-Aug;13(4):333-7
pubmed: 17669707
Clin Endocrinol (Oxf). 2018 Oct;89(4):489-495
pubmed: 30004132
Diagn Cytopathol. 2016 Nov;44(11):921-925
pubmed: 27392021
Diagn Cytopathol. 2008 Apr;36(4):227-31
pubmed: 18335560
Cytojournal. 2017 Apr 28;14:10
pubmed: 28567111
Diagn Cytopathol. 2017 Jun;45(6):526-532
pubmed: 28371486
Korean J Pathol. 2013 Oct;47(5):466-71
pubmed: 24255635
Cancer Cytopathol. 2013 Mar;121(3):155-61
pubmed: 22786745
Ann Surg. 2020 Mar;271(3):e21-e93
pubmed: 32079830
Cytopathology. 2017 Aug;28(4):273-279
pubmed: 28217943
VideoEndocrinology. 2018 Jun 07;5(2):
pubmed: 32025529