Three-dimensional cytomorphology in fine needle aspiration biopsy of parathyroid lesions.
OBJECTIVE
To elucidate three-dimensional (3-D) cytomorphology in fine needle aspiration biopsy (FNAB) of parathyroid lesions.


METHODS
Ultrasound-guided FNAB was performed on parathyroid lesions from 10 patients with hyperparathyroidism. The aspirates were stained and observed under a light microscope (LM). The aspirates were also fixed, dehydrated, critical point dried, spattered with gold ions and observed with a scanning electron microscope (SEM). Findings under SEM were correlated with the appearances under LM as well as with serum parathyroid hormone (PTH) concentrations.


RESULTS
Under LM, nine cases displayed isokaryosis and one case, anisokaryosis. These appearances corresponded to isocytosis or anisocytosis under SEM. Under SEM, 3-D cytomorphology of parathyroid lesions displayed isocytotic, scattered cells in five cases, uniform cellular arrangements in four cases and anisocytotic, scattered cells in one case. The cell surface was rather smooth in five cases. The other five cases had significant granules on the cell surfaces; these all had serum PTH concentrations > or = 268 pg/mL.


CONCLUSIONS
3-D cytomorphology in FNAB of parathyroid lesions was a rather smooth cell surface in cases with low serum PTH and a granular cell surface in cases with significantly increased serum PTH. These characteristics and the absence of microvilli might be helpful in the differential diagnosis between parathyroid and follicular thyroid lesions.
Chang
Tien-Chun
TC
Department of Internal Medicine, National Taiwan University College of Medicine, National Taiwan University Hospital, Taipei, Taiwan. tcchang1@ms10.hinet.net
Lai
Shu-Mei
SM
Wen
Chen-Yuan
CY
Hsiao
Yung-Lien
YL
Huang
Shih-Horng
SH
D000236:Adenoma / Q000473:pathology* / Q000648:ultrastructure; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000473:pathology*; D006965:Hyperplasia / Q000473:pathology; D021621:Imaging, Three-Dimensional; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010282:Parathyroid Neoplasms / Q000473:pathology* / Q000648:ultrastructure
D010281:Parathyroid Hormone