Ultrasound diagnosis of parathyroid cysts

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} </script> <script src="//translate.google.com/translate_a/element.js?cb=googleTranslateElementInit"></script> </ul> </div> </nav> <div class="container-fluid bg-grey"> <div class="container pt-3 pb-4"> <div class="white-container mt-4"> <h2 class="bg-hdr">Ultrasound diagnosis of parathyroid cysts</h2> <p style="padding-top: 8px;"><span lang="EN-US">Cysts of the parathyroid gland are rare, in most cases they are afunctional and misdiagnosed.</span></p> <p style="padding-top: 8px;"><span lang="EN-US">They can be accidentally detected during a neck examination for other reasons (thyroid disease).</span></p> <p style="padding-top: 8px;"><strong><span lang="EN-US">PATIENTS:</span></strong></p> <p style="padding-top: 8px;"><span lang="EN-US">We present 38 patients with echographic findings of cystic lesions that can be parathyroid cysts. 27 were women, 11 men, mean age 48 years (19-75). Parathyroid function was normal in 29 patients. 9 patients had primary hyperparathyroidism.</span></p> <p style="padding-top: 8px;"><strong><span lang="EN-US">METHODS:</span></strong></p> <p style="padding-top: 8px;"><span lang="EN-US">We used standard US equipment with linear high resolution probes, 10-17 MHz. Fine needle aspiration biopsy (FNAB) was performed by a &bdquo;free hand“ technique, using a thin needle of 22 G and a syringe of 20 ml. Parathormone  in aspirated material was determined  with IRMA (Beckman Coulter Inc.). Standard methods were used to determine Ca, P and PTH in serum. </span></p> <p style="padding-top: 8px;"><strong><span lang="EN-US">RESULTS: </span></strong></p> <p style="padding-top: 8px;"><span lang="EN-US">In 15 patients a typical cystic form was echographically found. With FNAB,  a clear, watery </span><span lang="EN-US">liquid,</span><span lang="EN-US"> was obtained (few drops to 135 ml), and PTH in aspirate was elevated (2-72 pmo/l).</span></p> <p style="padding-top: 8px;"><span lang="EN-US">In 16 patients hypoehogenic forms were found behind the thyroid without internal vascularization. With FNAB thick yellow or reddish content, like colloid, was obtained (few drops to 3 ml). PTH in aspirate was elevated in 9 patients (2 - >150 pmol/l), and in 7 patients PTH was low (0,2,-06 pmol/l), but cytologically parathyroid cells, including in colloid, were found. </span></p> <p style="padding-top: 8px;"><span lang="EN-US">In 7 patients, cystic – solid forms were found with or without internal vascularization. With FNAB, and cytological analysis of smears, 2 parathyroid adenoma were confirmed. Parathyroid cells with cystic degeneration were found in 3 aspirates, and in 2 aspirates cells of peripheral blood were found.  PTH was enormously elevated in all cases (43.7- >150 pmol/l).</span></p> <p style="padding-top: 8px;"><span lang="EN-US"><strong>CONCLUSION:</strong> </span></p> <p style="padding-top: 8px;"><span lang="EN-US">Ultrasound in combination with FNAB and PTH determination are the methods of choice for detecting parathyroid cysts.</span></p> <div class="border-top py-2"><b>Posted by: </b>Hrvojka Tomic-Brzac, M.D.. 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Ultrasound diagnosis of parathyroid cysts