Utility of parathyroid hormone immunocytochemistry in fine needle aspiration diagnosis of parathyroid tissue.
fine needle aspiration
immunocytochemistry
parathyroid hormone
parathyroid tissue
thyroid
Journal
Cytopathology : official journal of the British Society for Clinical Cytology
ISSN: 1365-2303
Titre abrégé: Cytopathology
Pays: England
ID NLM: 9010345
Informations de publication
Date de publication:
11 2023
11 2023
Historique:
revised:
08
07
2023
received:
30
04
2023
accepted:
18
07
2023
medline:
10
10
2023
pubmed:
3
8
2023
entrez:
3
8
2023
Statut:
ppublish
Résumé
The cytomorphological features of parathyroid tissue (PTT) may overlap with those of thyroid lesions, thus posing a diagnostic challenge. In this retrospective study, we reviewed our institutional experience in using parathyroid hormone (PTH) immunocytochemistry (ICC) to substantiate the diagnosis of PTT on fine needle aspiration (FNA). Our pathology database was searched for FNA cases in which PTH ICC was performed between 1 January 2015 and 31 March 2022. PTH ICC was performed on a ThinPrep slide in cases with a clinical suspicion of PTT or with cytomorphological features raising the possibility of PTT. Patients' clinicopathological characteristics, PTH ICC results, cytological diagnoses, and surgical follow-ups, if available, were reviewed and analysed. The study cohort included 103 cases clinically designated as thyroid (n = 85, 82.5%), parathyroid (n = 11, 10.7%) and neck soft tissue (n = 7, 6.8%). PTH immunostaining was negative, positive, and indeterminate in 53 (51.5%), 27 (26.2%), and 23 (22.3%) cases, respectively. Surgical follow-up was available in 27 (26.2%) cases, including 17 thyroid lesions and 10 PTT cases. All positive PTH cases were confirmed to be PTT, while all but one of the negative PTH cases were non-PTT on follow-up. The calculated sensitivity, specificity, positive and negative predictive values were 85.7%, 100%, 100% and 93.3%, respectively. Our study demonstrates that PTH ICC performed on additional ThinPrep slides is a valuable adjunct test in FNA samples with a differential diagnosis of PTT vs non-PTT. Low cellularity may be a limiting factor in the accurate assessment of PTH by ICC.
Substances chimiques
Parathyroid Hormone
0
Types de publication
Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
597-602Subventions
Organisme : Yale University School of Medicine Department of Pathology Research Histology Fund
Informations de copyright
© 2023 John Wiley & Sons Ltd.
Références
Dahiya N, Patel MD, Young SW. Neck procedures: thyroid and parathyroid. Radiol Clin North Am. 2020;58(6):1085-1098.
Kwak JY, Kim EK, Moon HJ, et al. Parathyroid incidentalomas detected on routine ultrasound-directed fine-needle aspiration biopsy in patients referred for thyroid nodules and the role of parathyroid hormone analysis in the samples. Thyroid. 2009;19(7):743-748.
Tamiya H, Miyakawa M, Suzuki H, et al. A large functioning parathyroid cyst in a patient with multiple endocrine neoplasia type 1. Endocr J. 2013;60(6):709-714.
Aydın C, Polat SB, Dellal FD, et al. The diagnostic value of parathyroid hormone washout in primary hyperparathyroidism patients with negative or equivocal 99 m Tc-MIBI results. Diagn Cytopathol. 2019;47(2):94-99.
Kuzu F, Arpaci D, Cakmak GK, et al. Focused parathyroidectomy without intra-operative parathormone monitoring: the value of PTH assay in preoperative ultrasound guided fine needle aspiration washout. Ann Med Surg (Lond). 2016;6:64-67.
Trimboli P, D'Aurizio F, Tozzoli R, Giovanella L. Measurement of thyroglobulin, calcitonin, and PTH in FNA washout fluids. Clin Chem Lab Med. 2017;55(7):914-925.
Ahmed M, Abi-Raad R, Fu L, Holt EH, Adeniran AJ, Cai G. Performing calcitonin immunocytochemistry on an additional ThinPrep slide in fine-needle aspiration diagnosis of medullary thyroid carcinoma. Am J Clin Pathol. 2022;157(3):426-433.
Heo I, Park S, Jung CW, et al. Fine needle aspiration cytology of parathyroid lesions. Korean J Pathol. 2013;47(5):466-471.
Suzuki A, Hirokawa M, Kanematsu R, et al. Fine-needle aspiration of parathyroid adenomas: indications as a diagnostic approach. Diagn Cytopathol. 2021;49(1):70-76.
Odronic SI, Reynolds JP, Chute DJ. Cytologic features of parathyroid fine-needle aspiration on ThinPrep preparations. Cancer Cytopathol. 2014;122(9):678-684.
Park GS, Lee SH, Jung SL, Jung CK. Liquid-based cytology in the fine needle aspiration of parathyroid lesions: a comparison study with the conventional smear, ThinPrep, and SurePath. Int J Clin Exp Pathol. 2015;8(10):12160-12168.
Rossi ED, Morassi F, Santeusanio G, Zannoni GF, Fadda G. Thyroid fine needle aspiration cytology processed by ThinPrep: an additional slide decreased the number of inadequate results. Cytopathology. 2010;21(2):97-102.
Cho M, Oweity T, Brandler TC, Fried K, Levine P. Distinguishing parathyroid and thyroid lesions on ultrasound-guided fine-needle aspiration: a correlation of clinical data, ancillary studies, and molecular analysis. Cancer Cytopathol. 2017;125(9):674-682.
Absher KJ, Truong LD, Khurana KK, Ramzy I. Parathyroid cytology: avoiding diagnostic pitfalls. Head Neck. 2002;24(2):157-164.
Giorgadze T, Stratton B, Baloch ZW, Livolsi VA. Oncocytic parathyroid adenoma: problem in cytological diagnosis. Diagn Cytopathol. 2004;31(4):276-280.
Tseleni-Balafouta S, Gakiopoulou H, Kavantzas N, Agrogiannis G, Givalos N, Patsouris E. Parathyroid proliferations: a source of diagnostic pitfalls in FNA of thyroid. Cancer. 2007;111(2):130-136.
Wong YP, Sharifah NA, Tan GC, Gill AJ, Ali SZ. Intrathyroidal oxyphilic parathyroid carcinoma: a potential diagnostic caveat in cytology? Diagn Cytopathol. 2016;44(8):688-692.
Abdelghani R, Noureldine S, Abbas A, Moroz K, Kandil E. The diagnostic value of parathyroid hormone washout after fine-needle aspiration of suspicious cervical lesions in patients with hyperparathyroidism. Laryngoscope. 2013;123(5):1310-1313.
Castellana M, Virili C, Palermo A, Giorgino F, Giovanella L, Trimboli P. Primary hyperparathyroidism with surgical indication and negative or equivocal scintigraphy: safety and reliability of PTH washout. A systematic review and meta-analysis. Eur J Endocrinol. 2019;181(3):245-253.
Bancos I, Grant CS, Nadeem S, et al. Risks and benefits of parathyroid fine-needle aspiration with parathyroid hormone washout. Endocr Pract. 2012;18(4):441-449.
Giusti M, Dolcino M, Vera L, et al. Institutional experience of PTH evaluation on fine-needle washing after aspiration biopsy to locate hyperfunctioning parathyroid tissue. J Zhejiang Univ Sci B. 2009;10(5):323-330.
Owens CL, Rekhtman N, Sokoll L, Ali SZ. Parathyroid hormone assay in fine-needle aspirate is useful in differentiating inadvertently sampled parathyroid tissue from thyroid lesions. Diagn Cytopathol. 2008;36(4):227-231.
Domingo RP, Ogden LL, Been LC, Kennedy GC, Traweek ST. Identification of parathyroid tissue in thyroid fine-needle aspiration: a combined approach using cytology, immunohistochemical, and molecular methods. Diagn Cytopathol. 2017;45(6):526-532.
Nikiforova MN, Mercurio S, Wald AI, et al. Analytical performance of the ThyroSeq v3 genomic classifier for cancer diagnosis in thyroid nodules. Cancer. 2018;124(8):1682-1690.
Puga FM, Rodrigues M, Eloy C. Usefulness of cellblock preparation in fine needle aspiration for the diagnosis of thyroid nodules. Diagn Cytopathol. 2022;50(9):419-423.
Shi Y, Brandler TC, Yee-Chang M, et al. Application of GATA 3 and TTF-1 in differentiating parathyroid and thyroid nodules on cytology specimens. Diagn Cytopathol. 2020;48(2):128-137.
Erdogan-Durmus S, Ramazanoglu SR, Barut HY. Diagnostic significance of GATA 3, TTF-1, PTH, chromogranin expressions in parathyroid fine needle aspirations via immuonocytochemical method. Diagn Cytopathol. 2023;51:449-454.