Relationship of technetium Tc 99m sestamibi scans to histopathological features of hyperfunctioning parathyroid tissue.
OBJECTIVE
To investigate the histopathological features of pathologic parathyroid specimens associated with negative preoperative technetium Tc 99m sestamibi scans.


METHODS
Retrospective study.


METHODS
Tertiary care center.


METHODS
One hundred fourteen patients who underwent sestamibi scans before surgical exploration for primary hyperparathyroidism between 1996 and 2001.


METHODS
Surgical exploration and removal of parathyroid adenomas.


METHODS
Histopathological characteristics associated with true-positive and false-negative sestamibi scans, including parathyroid specimen weight, size, relative oxyphil and chief cell content, parathyroid hormone staining patterns, cellular architecture, and various immunohistochemical staining patterns.


RESULTS
Twenty-three (24%) of 98 patients with parathyroid adenomas had negative sestamibi scan results. Among 20 age- and sex-matched patients with false-negative results vs 20 patients with true-positive results, tumor size (P = .04) and oxyphil cell content (P = .03) were found to be significantly different.


CONCLUSIONS
Parathyroid gland size and oxyphil content are descriptive and predict differences between sestamibi properties of parathyroid adenomas but have no current therapeutic implications for parathyroid surgery.
Mehta
Nicholas Y
NY
Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati School of Medicine, Cincinnati, Ohio, USA.
Ruda
James M
JM
Kapadia
Silloo
S
Boyer
Phillip J
PJ
Hollenbeak
Christopher S
CS
Stack
Brendan C
BC
D000236:Adenoma / Q000000981:diagnostic imaging / Q000473:pathology; D005188:False Negative Reactions; D005189:False Positive Reactions; D006801:Humans; D006961:Hyperparathyroidism / Q000000981:diagnostic imaging* / Q000473:pathology*; D007150:Immunohistochemistry; D010282:Parathyroid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi