Importance of Fine Needle Aspiration Washout Method in Localization of Parathyroid Adenomas Caused by Primary Hyperparathyroidism
Journal Title: Hippocrates Medical Journal - Year 2022, Vol 2, Issue 3
Abstract
Aim: Although ultrasonography (USG) and scintigraphy are frequently used in the detection of parathyroid adenomas, they are sometimes insufficient for this task. This situation leads to failures in surgical treatment. Measurement of parathormone (PTH) in the washout fluid obtained by USG-guided fine needle aspiration (FNA) is easy, cost-effective and safe, and can be used to localize the parathyroid lesion. We aimed to present our cases in which we measured PTH in the washing liquid obtained by FNA and review the literature. Method: A total of 16 cases were evaluated retrospectively, and age, gender, laboratory values, imaging, DEXA reports and pathology results of the operated patients were recorded. For the measurement of PTH in the washout liquid, negative aspiration was performed from the suspicious lesion with a 10 mL/22 gauge needle and the aspirated needle was rinsed with 1 mL of 0.9% NaCl and PTH was measured from the washing liquid. A washout PTH value higher than the serum value was considered as positive. Results: Thirteen of the patients were female and 3 were male, with a mean age of 57.1 ± 14.2 (18-73) years. Washout PTH result was positive in 3 patients with involvement in scintigraphy, negative in 5 patients without involvement, and positive in 2 patients with suspicious involvement. Washout PTH result was positive in 4 patients without involvement in scintigraphy, and 44.5% positive result were detected with this method in those without involvement. Although there was involvement in scintigraphy, the washing result of 2 patients was negative. No procedure-related side effects occurred in any of the patients Conclusion: PTH measurement in the FNA washing fluid performed under ultrasonography is a procedure that can be safely performed by experienced people in selected cases whose location cannot be determined by USG and scintigraphy, or with suspicious involvement in scintigraphy and without suspected cancer.
Authors and Affiliations
Mehmet Ali EREN, Gizem ILGIN KAPLAN, Hüseyin KARAASLAN, Sanem KILINC, Nida UYAR Tevfik SABUNCU
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