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Journal of Zhejiang University SCIENCE B 2009 Vol.10 No.5 P.323~330

10.1631/jzus.B0820372


Institutional experience of PTH evaluation on fine-needle washing after aspiration biopsy to locate hyperfunctioning parathyroid tissue


Author(s):  Massimo GIUSTI, Mara DOLCINO, Lara VERA, Carla GHIARA, Francesca MASSARO, Laura FAZZUOLI, Diego FERONE, Michele MUSSAP, Francesco MINUTO

Affiliation(s):  Department of Endocrinology, San Martino University Hospital, I-16100 Genoa, Italy; more

Corresponding email(s):   magius@unige.it

Key Words:  Primary hyperparathyroidism, Nodular goitre, Scintigraphy, Ultrasonography, Fine-needle aspiration biopsy (FNAB), Parathyroid hormone (PTH)-FNAB


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Massimo GIUSTI, Mara DOLCINO, Lara VERA, Carla GHIARA, Francesca MASSARO, Laura FAZZUOLI, Diego FERONE, Michele MUSSAP, Francesco MINUTO. Institutional experience of PTH evaluation on fine-needle washing after aspiration biopsy to locate hyperfunctioning parathyroid tissue[J]. Journal of Zhejiang University Science B, 2009, 10(5): 323~330.

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author="Massimo GIUSTI, Mara DOLCINO, Lara VERA, Carla GHIARA, Francesca MASSARO, Laura FAZZUOLI, Diego FERONE, Michele MUSSAP, Francesco MINUTO",
journal="Journal of Zhejiang University Science B",
volume="10",
number="5",
pages="323~330",
year="2009",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B0820372"
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%0 Journal Article
%T Institutional experience of PTH evaluation on fine-needle washing after aspiration biopsy to locate hyperfunctioning parathyroid tissue
%A Massimo GIUSTI
%A Mara DOLCINO
%A Lara VERA
%A Carla GHIARA
%A Francesca MASSARO
%A Laura FAZZUOLI
%A Diego FERONE
%A Michele MUSSAP
%A Francesco MINUTO
%J Journal of Zhejiang University SCIENCE B
%V 10
%N 5
%P 323~330
%@ 1673-1581
%D 2009
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B0820372

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T1 - Institutional experience of PTH evaluation on fine-needle washing after aspiration biopsy to locate hyperfunctioning parathyroid tissue
A1 - Massimo GIUSTI
A1 - Mara DOLCINO
A1 - Lara VERA
A1 - Carla GHIARA
A1 - Francesca MASSARO
A1 - Laura FAZZUOLI
A1 - Diego FERONE
A1 - Michele MUSSAP
A1 - Francesco MINUTO
J0 - Journal of Zhejiang University Science B
VL - 10
IS - 5
SP - 323
EP - 330
%@ 1673-1581
Y1 - 2009
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B0820372


Abstract: 
Assaying parathyroid hormone (PTH) in the washing liquid after fine-needle aspiration biopsy (FNAB) seems to be a valid approach to locate parathyroid tissue. PTH-FNAB was evaluated in 47 patients with a clinical picture of primary hyperparathyroidism (PHP) and ultrasonography (US) suggestive of parathyroid lesion. The patients were subdivided into two groups on the basis of the absence or presence of US thyroid alterations. The result of PTH-FNAB was compared with those of cytology, scintigraphy and, in 24 patients, surgical outcome. PTH-FNAB samples with a value higher than that recorded in the serum and higher than our institutional cut-off were deemed to be probable samples of parathyroid tissue. Cytology proved diagnostic for benign thyroid lesions, non-diagnostic for thyroid lesions, hyperplastic parathyroid tissue, undetermined or malignant thyroid lesions and other lesions in 45%, 30%, 17%, 4%, and 4% of cases, respectively. In 47% of cases, PTH-FNAB indicated that the sample had been taken in parathyroid tissue. In patients without US alterations, the diagnostic accuracy of PTH-FNAB was greater than that of scintigraphy. After surgery, comparison between the results of PTH-FNAB and scintigraphy, in terms of positive predictive value (PPV), revealed the superiority of PTH-FNAB; PPV was 94% for FNAB and 71% for scintigraphy, while sensitivity was 83% and 69%, respectively. PTH-FNAB evaluation after FNAB appears to be more diagnostic than cytology and scintigraphy. Of all the procedures used, PTH-FNAB appears to be the method of choice when the target is US suggestive and reachable. PTH-FNAB appears to be a useful method of guiding surgical intervention.

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