Recurrent secondary hyperparathyroidism after autotransplantation into the sternocleidomastoid muscle: report of a case with fine needle aspiration findings.
BACKGROUND
Recurrent hyperparathyroidism may occur following parathyroid autotransplantation due to autogenous function of the muscle-engrafted tissue. Parathyroid lesions are uncommonly diagnosed on cytology.


METHODS
A 31-year-old female with chronic renal failure presented with an elevated parathyroid hormone level and a neck mass in the left sternocleidomastoid muscle, the site of a previous parathyroid autograft. Fine needle aspiration of the mass revealed high cellularity, with perivascularly arranged, three-dimensional, branching clusters; individual cells; and naked nuclei exhibiting anisonucleosis. A diagnosis of parathyroid graft hyperplasia was made by fine needle aspiration and subsequently by histopathologic examination.


CONCLUSIONS
Fine needle aspiration is an effective tool for confirming the presence of parathyroid autograft hyperplasia, thus allowing the correct surgical approach.
Department of Pathology and Laboratory Medicine, University of California, Los Angeles 90095-1732, USA.
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D
Lieu
S L
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Hirschowitz
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KA
Skinner
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Zuckerbraun
D000328:Adult; D001707:Biopsy, Needle; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000209:etiology* / Q000473:pathology*; D006965:Hyperplasia; D009334:Neck Muscles / Q000473:pathology* / Q000601:surgery; D010280:Parathyroid Glands / Q000473:pathology / Q000601:surgery / Q000637:transplantation*; D012008:Recurrence; D014182:Transplantation, Autologous / Q000009:adverse effects*