title: Thyroid evaluation in patients with primary hyperparathyroidism.
abstract: We evaluated the efficacy of preoperative high-resolution ultrasonography (US) for diagnosing possible concomitant thyroid disease which affects the surgical management in patients with primary hyperparathyroidism (pHPT). One hundred and nine patients with sporadic pHPT underwent US with or without ultrasound-guided fine-needle aspiration biopsy (US-FNAB). Diagnosis of concomitant thyroid nodules by US and US-FNAB were compared with the histopathological findings. Of the 109 patients, 19 (17.4%) had malignant thyroid nodules, 26 (23.9%) had benign thyroid nodules alone, and 12 (11.0%) had diffuse goiter. The sensitivity, specificity, and accuracy of diagnosing 72 thyroid nodules were 91.3%, 91.8%, and 91.7% for US, 57.9%, 94.3%, and 81.5% for US-FNAB, and 95.7%, 91.8%, and 93.1% for combined US and US-FNAB, respectively. True positive/false negative ratio of US-FNAB diagnosis was significantly lower in nodules of 5-9 mm than nodules of 10 mm or more. Four unexpected thyroid cancers existed at a different site in 3 of the 39 patients with palpable thyroid disease. Five thyroid cancers were histopathologically confirmed in 5 (7.1%) of 70 patients without palpable thyroid disease. Eight (88.9%) of the 9 non-palpable thyroid cancers were accurately diagnosed by combined US and US-FNAB. Preoperative US is useful for evaluation of possible concomitant thyroid disease, especially for prediction of malignancy.
authors.affiliation: Noguchi Thyroid Clinic and Hospital Foundation, Beppu, Oita, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Masatsugu
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamashita
authors.forename: Shiro
authors.initials: S
authors.lastname: Noguchi
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Nishii
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Koga
authors.forename: Shin
authors.initials: S
authors.lastname: Watanabe
authors.forename: Shinya
authors.initials: S
authors.lastname: Uchino
authors.forename: Hiroto
authors.initials: H
authors.lastname: Yamashita
authors.forename: Akira
authors.initials: A
authors.lastname: Ohshima
authors.forename: Syoji
authors.initials: S
authors.lastname: Kuroki
authors.forename: Masao
authors.initials: M
authors.lastname: Tanaka
mesh_terms: D000236:Adenoma / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D002118:Calcium / Q000097:blood / Q000652:urine; D002291:Carcinoma, Papillary / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006042:Goiter / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D006111:Graves Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D006961:Hyperparathyroidism / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010710:Phosphates / Q000097:blood; D012680:Sensitivity and Specificity; D013959:Thyroid Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D013964:Thyroid Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D016606:Thyroid Nodule / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D013966:Thyroiditis / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography
chemical_list: D010281:Parathyroid Hormone; D010710:Phosphates; D002118:Calcium