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Ultrasonography of the Parathyroid Glands

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Thyroid Ultrasound and Ultrasound-Guided FNA

Abstract

Primary hyperparathyroidism (PHPT) is a common condition affecting approximately 100,000 new patients each year in the USA [1]. An apparent increase in the incidence was traced to the wide availability and the use of multichannel analyzers for routine testing. This has resulted in the early detection of subclinical disease since 1970[2]. The technological advancement in multichannel analyzers and the easy availability of biochemical testing have changed the disease presentation of PTHP. The majority of subjects presents well before onset of symptoms or end organ damage. In more than 85 % of these cases, a solitary adenoma is the cause of the problem. Accurate localization of the adenoma enables minimally invasive surgery to be performed, often as an outpatient surgery or with shortened hospitalization and recuperative times [3].

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References

  1. Kebebew E, Clark OH. Parathyroid adenoma, hyperplasia and carcinoma: localization, technical details of primary neck exploration and treatment of hypercalcemic crisis. Surg Oncol Clin N Am. 1998;7:721–48.

    PubMed  CAS  Google Scholar 

  2. Heath III H, Hodgson SF, Kennedy M. Primary hyperparathyroidism: incidence, morbidity and potential economic impact in a community. N Engl J Med. 1980;302:189–93.

    Article  PubMed  Google Scholar 

  3. Udelsman R, Donovan PI. Open minimally invasive parathyroid surgery. World J Surg. 2004;28(12):1224–6.

    Article  PubMed  Google Scholar 

  4. Owen R. On the anatomy of the Indian Rhinoceros (Rh. Unicornis L.). Trans Zool Soc Lond. 1862;4:31–58.

    Google Scholar 

  5. Gilmore JR. The gross anatomy of parathyroid glands. J Pathol. 1938;46:133.

    Article  Google Scholar 

  6. Alveryd A. Parathyroid glands in thyroid surgery. Acta Chir Scand. 1968;389:1.

    PubMed  CAS  Google Scholar 

  7. Wang CA, Mahaffey JE, Axelrod L, et al. Hyperfunctioning supernumerary parathyroid glands. Surg Gynecol Obstet. 1979;148:711.

    PubMed  CAS  Google Scholar 

  8. Akerstrom G, Malmaeus J, Bergstrom R. Surgical anatomy of human parathyroid glands. Surgery. 1984;95:14.

    PubMed  CAS  Google Scholar 

  9. Cheung K, Wang TS, Farrokhyar F, Roman SA, Sosa JA. A meta-analysis of preoperative localization techniques for patients with primary hyperparathyroidism. Ann Surg Oncol. 2012;19(2):577–83.

    Article  PubMed  Google Scholar 

  10. Yeh MW, Barraclough BM, Sidhu SB, Sywak MS, Barraclough BH, Delbridge LW. Two hundred consecutive parathyroid ultrasound studies by a single clinician: the impact of experience. Endocr Pract. 2006;12(3):257–63.

    PubMed  Google Scholar 

  11. Andre V, Andre M, Le Dreff P, Granier H, Forlodou P, Garcia JF. Intrathyroid parathyroid adenoma. J Radiol. 1999;80(6):591–2.

    PubMed  CAS  Google Scholar 

  12. McIntyre Jr R, Eisenach J, Pearlman N, Ridgeway C, Dale Liechty R. Intrathyroidal parathyroid glands can be a cause of failed cervical exploration for hyperparathyroidism. Am J Surg. 1997;174(6):750–4.

    Article  PubMed  Google Scholar 

  13. Kamaya A, Quon A, Jeffrey RB. Sonography of the abnormal parathyroid gland. Ultrasound Q. 2006;22(4):253–62.

    Article  PubMed  Google Scholar 

  14. Lane MJ, Desser TS, Weigel RJ, Jeffrey Jr RB. Use of color and power Doppler sonography to identify feeding arteries associated with parathyroid adenomas. AJR Am J Roentgenol. 1998;171(3):819–23.

    PubMed  CAS  Google Scholar 

  15. Wolf RJ, Cronan JJ, Monchik JM. Color Doppler sonography: an adjunctive technique in assessment of parathyroid adenomas. J Ultrasound Med. 1994;13(4):303–8.

    PubMed  CAS  Google Scholar 

  16. Harari A, Mitmaker E, Grogan RH, Lee J, Shen W, Gosnell J, et al. Primary hyperparathyroidism patients with positive preoperative sestamibi scan and negative ultrasound are more likely to have posteriorly located upper gland adenomas (PLUGs). Ann Surg Oncol. 2011;18(6):1717–22.

    Article  PubMed  Google Scholar 

  17. Pesenti M, Frasoldati A, Azzarito C, Valcavi R. Parathyroid incidentaloma discovered during thyroid ultrasound imaging. J Endocrinol Invest. 1999;22(10):796–9.

    PubMed  CAS  Google Scholar 

  18. Frasoldati A, Pesenti M, Toschi E, Azzarito C, Zini M, Valcavi R. Detection and diagnosis of parathyroid incidentalomas during thyroid sonography. J Clin Ultrasound. 1999;27(9):492–8.

    Article  PubMed  CAS  Google Scholar 

  19. Doppman JL, Krudy AG, Marx SJ, Saxe A, Schneider P, Norton JA, et al. Aspiration of enlarged parathyroid glands for parathyroid hormone assay. Radiology. 1983;148(1):31–5.

    PubMed  CAS  Google Scholar 

  20. Abraham D, Sharma PK, Bentz J, Gault PM, Neumayer L, McClain DA. The utility of ultrasound guided FNA of parathyroid adenomas for pre-operative localization prior to minimally invasive parathyroidectomy. Endocr Pract. 2007;13(4):333–7.

    PubMed  Google Scholar 

  21. Norman J, Politz D, Browarski E. Diagnostic aspiration of parathyroid adenomas causes severe fibrosis complicating surgery and final histologic diagnosis. Thyroid. 2007;17(12):1251–5.

    Article  PubMed  Google Scholar 

  22. Abraham D, Duick AS, Baskin HJ. Appropriate administration of fine-needle aspiration (FNA) biopsy on selective parathyroid adenomas is safe. Thyroid. 2008;18(5):581–2.

    Article  PubMed  Google Scholar 

  23. Agarwal AM, Bentz JS, Hungerford R, Abraham D. Parathyroid fine-needle aspiration cytology in the evaluation of parathyroid adenoma: cytologic findings from 53 patients. Diagn Cytopathol. 2009;37:407–10.

    Article  PubMed  Google Scholar 

  24. Krause UC, Friedrich JH, Olbricht T, Metz K. Association of primary hyperparathyroidism and non-medullary thyroid cancer. Eur J Surg. 1996;162(9):685–9.

    PubMed  CAS  Google Scholar 

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Correspondence to Dev Abraham MD, MRCP .

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Abraham, D. (2013). Ultrasonography of the Parathyroid Glands. In: Baskin, Sr., H., Duick, D., Levine, R. (eds) Thyroid Ultrasound and Ultrasound-Guided FNA. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4785-6_9

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  • DOI: https://doi.org/10.1007/978-1-4614-4785-6_9

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