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Diagnosis of parathyroid incidentaloma detected on thyroid ultrasonography: the role of fine-needle aspiration cytology and washout parathyroid hormone measurements

Title
Diagnosis of parathyroid incidentaloma detected on thyroid ultrasonography: the role of fine-needle aspiration cytology and washout parathyroid hormone measurements
Authors
Lee B.Chung S.R.Choi Y.J.Sung T.-Y.Song D.E.Kim T.Y.Lee J.H.Baek J.H.
Ewha Authors
이보은
SCOPUS Author ID
이보은scopusscopusscopus
Issue Date
2023
Journal Title
Ultrasonography
ISSN
2288-5919JCR Link
Citation
Ultrasonography vol. 42, no. 1, pp. 129 - 135
Keywords
Fine-needle aspiration cytologyNeck ultrasonographyParathyroid hormoneParathyroid incidentaloma
Publisher
Korean Society of Ultrasound in Medicine
Indexed
SCIE; SCOPUS; KCI scopus
Document Type
Article
Abstract
Purpose: The aim of this study was to assess the diagnostic role of fine-needle aspiration cytology (FNAC) and analyze factors associated with false-negative FNAC results in patients with parathyroid incidentaloma who were referred for ultrasonography (US)-guided fine-needle aspiration (FNA) of thyroid nodules. Methods: In this study, 121 patients with suspected parathyroid lesions were enrolled. The patients underwent US-guided FNAC with measurements of washout parathyroid hormone (PTH) between January 2015 and May 2020. The diagnostic performance of FNAC for the diagnosis of parathyroid lesions was assessed using surgical results and elevated washout PTH as a reference standard. The clinical and radiologic features associated with false-negative results on FNAC for the diagnosis of parathyroid lesions were evaluated. Results: Among the 121 nodules assessed, 38 were parathyroid lesions (31.4%), and 83 were non-parathyroid lesions (68.6%). The diagnostic performance of FNAC for parathyroid incidentaloma showed a sensitivity of 31.6% (12/38), specificity of 100% (83/83), positive predictive values of 100% (12/12), negative predictive values of 76.1% (83/109), and accuracy of 78.5% (95/121). The FNAC results of non-parathyroid lesions included thyroid nodules, lymph nodes, neurogenic tumors, and fat tissue. True-positive results on FNAC were significantly associated with performing FNA twice (58.3% vs. 23.1%, P=0.043). Conclusion: Considering the low sensitivity of FNAC, measuring washout PTH in addition to FNAC may help accurately diagnose parathyroid incidentaloma on thyroid US. Further, the false-negative rate for FNAC can be reduced by obtaining two or more FNA samples. © 2023 Korean Society of Ultrasound in Medicine (KSUM).
DOI
10.14366/usg.22105
Appears in Collections:
의과대학 > 의학과 > Journal papers
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