open access

Vol 65, No 1 (2014)
Original papers
Published online: 2014-02-19
Submitted: 2014-02-19
Accepted: 2014-02-19
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Usefulness of PTH measurements in FNAB washouts in the identification of pathological parathyroids — analysis of the factors that influence the effectiveness of this method

Bożena Popowicz, Mariusz Klencki, Stanisław Sporny, Joanna Jankiewicz-Wika, Jan Komorowski, Hanna Pisarek, Dorota Słowińska-Klencka
DOI: 10.5603/EP.2014.0004
·
Endokrynologia Polska 2014;65(1):25-32.

open access

Vol 65, No 1 (2014)
Original papers
Published online: 2014-02-19
Submitted: 2014-02-19
Accepted: 2014-02-19

Abstract

Introduction: The aim of this investigation was to assess the usefulness of the measurement of PTH concentration in the material obtained during FNAB (PTH-FNAB) in the identification of pathological parathyroids in patients with frequently coexisting thyroid abnormalities (nodular goitre, chronic thyroiditis, previous thyroidectomy). Additionally, the influence of the size of goitre, parathyroid localisation and size on the results of PTH-FNAB measurement was examined.

Material and methods: Fifty patients with primary hyperparathyroidism and sonographically detected focal lesion that was suggestive of parathyroid gland were included in this study. PTH-FNAB results were correlated with the outcome of routine cytological examination and biochemical indices of hyperparathyroidism, SPECT-CT (33 patients) and histopathological examination (20 patients).

Results: Positive PTH-FNAB was observed in 80% of patients, and in more than 70% of persons with non-diagnostic smears or smears ‘contaminated’ with thyroid follicular cells. In the group of operated patients, sensitivity of PTH-FNAB (95.0%) was higher than SPECTCT (64.3%, p < 0.05). Presence of nodular goitre and/or chronic thyroiditis exerts a two times stronger negative effect on percentage of negative results of SPECT-CT than of PTH-FNAB. On the other hand, lower frequency of positive PTH-FNAB but not SPECT-CT was observed when the thickness of the thyroid was ≥ 20 mm (50% v. 87.5%, p < 0.05) and when the thickness of a lesion suspected of parathyroid pathology was ≤ 5 mm (66.7% v. 93.3%, p < 0.05).

Conclusions: In patients with thyroid abnormalities, PTH-FNAB measurements show advantages over routine biopsy and SPECT-CT in the identification of typically located pathological parathyroids. (Endokrynol Pol 2014; 65 (1): 25–32)

Abstract

Introduction: The aim of this investigation was to assess the usefulness of the measurement of PTH concentration in the material obtained during FNAB (PTH-FNAB) in the identification of pathological parathyroids in patients with frequently coexisting thyroid abnormalities (nodular goitre, chronic thyroiditis, previous thyroidectomy). Additionally, the influence of the size of goitre, parathyroid localisation and size on the results of PTH-FNAB measurement was examined.

Material and methods: Fifty patients with primary hyperparathyroidism and sonographically detected focal lesion that was suggestive of parathyroid gland were included in this study. PTH-FNAB results were correlated with the outcome of routine cytological examination and biochemical indices of hyperparathyroidism, SPECT-CT (33 patients) and histopathological examination (20 patients).

Results: Positive PTH-FNAB was observed in 80% of patients, and in more than 70% of persons with non-diagnostic smears or smears ‘contaminated’ with thyroid follicular cells. In the group of operated patients, sensitivity of PTH-FNAB (95.0%) was higher than SPECTCT (64.3%, p < 0.05). Presence of nodular goitre and/or chronic thyroiditis exerts a two times stronger negative effect on percentage of negative results of SPECT-CT than of PTH-FNAB. On the other hand, lower frequency of positive PTH-FNAB but not SPECT-CT was observed when the thickness of the thyroid was ≥ 20 mm (50% v. 87.5%, p < 0.05) and when the thickness of a lesion suspected of parathyroid pathology was ≤ 5 mm (66.7% v. 93.3%, p < 0.05).

Conclusions: In patients with thyroid abnormalities, PTH-FNAB measurements show advantages over routine biopsy and SPECT-CT in the identification of typically located pathological parathyroids. (Endokrynol Pol 2014; 65 (1): 25–32)

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Keywords

PTH; parathyroid; FNAB; thyroid

About this article
Title

Usefulness of PTH measurements in FNAB washouts in the identification of pathological parathyroids — analysis of the factors that influence the effectiveness of this method

Journal

Endokrynologia Polska

Issue

Vol 65, No 1 (2014)

Pages

25-32

Published online

2014-02-19

DOI

10.5603/EP.2014.0004

Bibliographic record

Endokrynologia Polska 2014;65(1):25-32.

Keywords

PTH
parathyroid
FNAB
thyroid

Authors

Bożena Popowicz
Mariusz Klencki
Stanisław Sporny
Joanna Jankiewicz-Wika
Jan Komorowski
Hanna Pisarek
Dorota Słowińska-Klencka

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