Ultrasonic localization and cytologic identification of parathyroid tumors
Tóm tắt
Ultrasonic examination of the parathyroid glands was performed in 55 consecutive patients with subsequent surgically verified hyperparathyroidism. Ultrasound located 26 of 37 parathyroid adenomas in the neck. Eleven of 48 hyperplastic glands in the neck were visualized by ultrasound in 16 patients with primary or uremic hyperplasia. A parathyroid adenoma was revealed in all 3 patients with hypercalcemic crisis and in all 5 patients with an adenoma and a previously unsuccessful exploration of the neck. Two of 3 glands were visualized by ultrasound prior to secondary explorations in 3 patients with primary hyperplasia associated with the multiple endocrine neoplasia syndrome type I. Undetected parathyroid glands were generally small and located in regions of the neck difficult to detect by ultrasound. It was often difficult to unequivocally establish that identified lesions represented a parathyroid gland. Nodules and cysts of the thyroid and lymph nodes were misinterpreted for parathyroid lesions. Ultrasonically guided fine-needle biopsies were obtained from 8 parathyroid lesions, 7 thyroid tumors, and 2 lymph nodes. By cytologic examination these tissues could be discriminated after a differential staining of the aspirates.
Tài liệu tham khảo
Sample, W.F., Mitchell, S.P., Bledsoe, R.C.: Parathyroid ultrasonography. Radiology127:485, 1978
Barraclough, B.H., Reeve, T.S., Duffy, P.J., Picker, R.H.: The localization of parathyroid tissue by ultrasound scanning prior to surgery in patients with hyperparathyroidism. World J. Surg.5:91, 1981
Simeone, J.F., Mueller, P.R., Ferrucci, J.T., van Sonnenberg, E., Wang, C.-A., Hall, D.A., Wittenberg, J.: High-resolution real-time sonography of the parathyroid. Radiology141:745, 1981
May, G.R., James, E.M., Johnson, C.M.: The radiologist's role in acute endocrine problems. World J. Surg.6:725, 1982
van Heerden, J.A., James, E.M., Karsell, P.R., Charboneau, J.W., Grant, C.S., Purnell, D.C.: Small-part ultrasonography in primary hyperparathyroidism. Ann. Surg.195:774, 1982
Rastad, J., Lindgren, P.G., Ljunghall, S., Johansson, H., Åkerström, G.: Ultrasound scanning for preoperative location of parathyroid tumours. Acta Chir. Scand.150:199, 1984
Lindgren, P.G.: Ultrasonically guided punctures—a modified technique. Radiology137:235, 1980
Sevier, A.C., Munger, B.L.: A silver method for paraffine sections of neural tissue. J. Neuropath. Exp. Neurol.24:130, 1965
Edis, A.J., Sheedy, P.F., Beahrs, O.H., van Heerden, J.A.: Results of reoperation for hyperparathyroidism, with evaluation of preoperative localization studies. Surgery84:384, 1978
Arima, M., Yokoi, H., Sonoda, T.: Preoperative identification of tumor of the parathyroid gland by ultrasonotomography. Surg. Gynecol. Obstet.141:242, 1975
Duffy, P., Picker, R.H., Duffield, S., Reeve, T., Hewlett, S.: Parathyroid sonography: A useful aid to preoperative localization. J. Clin. Ultrasound8:113, 1980
Edis, A.J., Evans, T.C.: High-resolution, real-time ultrasonography in the preoperative location of parathyroid tumors. N. Engl. J. Med.301:532, 1979
Leopold, G.R.: Ultrasonography of superficially located structures. Radiol. Clin. North Am.18:161, 1980
Scheible, W., Deutsch, A.L., Leopold, G.R.: Parathyroid adenoma: Accuracy of preoperative localization by high-resolution real-time sonography. J. Clin. Ultrasound9:325, 1981
Satava, R.M., Beahrs, O.H., Scholz, D.A.: Success rate of cervical exploration for hyperparathyroidism. Arch. Surg.110:625, 1975
van Heerden, J.A., Beahrs, O.H., Woolner, L.B.: The pathology and surgical management of primary hyperparathyroidism. Surg. Clin. North Am.57:557, 1977
Bruining, H.A., van Houten, H., Juttman, J.R., Lamberts, S.W.J., Birkenhäger, J.C.: The results of operative treatment of 615 patients with primary hyperparathyroidism. World J. Surg.5:85, 1981
Egdahl, R.H.: Preoperative parathyroid localization. N. Engl. J. Med.301:548, 1979
Clark, O.H., Gooding, G.A.W., Ljung, B.M.: Locating a parathyroid adenoma by ultrasonography and aspiration biopsy cytology. West. J. Med.135:154, 1981
Rastad, J., Grimelius, L., Johansson, H., Lindgren, P.G., Ljunghall, S., Stenkvist, B., Åkerström, G.: Ultrasound and fine needle biopsy in preoperative location of parathyroid adenomas. Acta Soc. Med. Suecanae91:10P, 1982
Doppman, J.L., Krudy, A.G., Marx, S.J., Saxe, A., Schneider, P., Norton, J.A., Spiegel, A.M., Downs, R.W., Schaaf, M., Brennan, M.E., Schneider, A.B., Aurbach, G.D.: Aspiration of enlarged parathyroid glands for parathyroid hormone assay. Radiology148:31, 1983
Solbiati, L., Montali, G., Croce, F., Bellotti, E., Giangrande, A., Ravetto, C.: Parathyroid tumors detected by fine-needle aspiration biopsy under ultrasonic guidance. Radiology148:793, 1983
