Endoscopic ultrasound-guided fine-needle aspiration with aspirate assay to diagnose suspected mediastinal parathyroid adenomas.
OBJECTIVE
To describe our experience with mediastinal parathyroid adenomas diagnosed by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and measurement of parathyroid hormone.


METHODS
We describe the clinical and pathologic findings and diagnostic techniques used in 2 study patients.


RESULTS
Patient 1 was a 54-year-old man with persistently elevated serum calcium and parathyroid hormone concentrations despite removal of a right inferior parathyroid adenoma. An echoendoscope was used to identify the lesion and to perform FNA. The parathyroid hormone concentration measured in the aspirated material was 1800 pg/mL. Pathologic examination of the resected specimen revealed a 29.7-g parathyroid adenoma. Patient 2 was an 86-year-old woman with recurrent hyperparathyroidism. A linear array echoendoscope was used to perform FNA of the lesion in her mediastinum. The parathyroid hormone concentration measured in the aspirated specimen was 6905 pg/mL.


CONCLUSIONS
Preoperative localization of recurrent or persistent hyperparathyroidism is often difficult. EUS-FNA allows evaluation of masses, such as those found in the mediastinum, that are poorly evaluated by other imaging modalities. This technique may be a useful adjunct in diagnosing mediastinal parathyroid adenomas.
Vu
Duc H
DH
Department of Gastroenterology, Scott and White Memorial Hospital and Clinic, Temple, Texas, USA. dvu@swmail.sw.org
Erickson
Richard A
RA
D044963:Biopsy, Fine-Needle / Q000379:methods*; D006801:Humans; D008297:Male; D008482:Mediastinum / Q000000981:diagnostic imaging / Q000473:pathology*; D008875:Middle Aged; D010282:Parathyroid Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014463:Ultrasonography