title: Rapid intraoperative parathyroid hormone assay in fine needle aspiration for differential diagnosis in thyroid and parathyroid surgery.
abstract: BACKGROUND
  The purpose of our study was to investigate the efficacy of rapid intraoperative parathyroid hormone (rIO-PTH) analysis performed using material collected by fine needle aspiration as a parameter to distinguish anatomical structures which the surgeon is not able to identify clearly as parathyroid or lymph node during thyroid/parathyroid surgery. Before surgery, all patients gave written, informed consent.
  
  
  METHODS
  We measured the rIO-PTH on 50 anatomical structures, 32 presumed parathyroids and 18 presumed lymph nodes from 22 patients, who underwent thyroid/parathyroid surgery between May and September 2009.
  
  
  RESULTS
  The rIO-PTH values obtained on parathyroids ranged from 85.4 pmol/L to more than 2106 pmol/L, with a rIO-PTH median of 263.25 pmol/L. Results obtained on lymph nodes ranged from <0.52 pmol/L up to 20.4 pmol/L, with a rIO-PTH median equal to 1.31 pmol/L. Results of the Mann-Whitney test showed a rIO-PTH median significantly different (p<0.0001) between samples obtained from parathyroid glands and lymph node tissue.
  
  
  CONCLUSIONS
  We demonstrated that rapid intraoperative measurement of parathyroid hormone is a good parameter for the differential diagnosis of parathyroid vs. lymph node tissue. We suggest extending the use of this technique to the field of parathyroid preservation during thyroid/parathyroid surgery in those cases where the parathyroids prove difficult to recognize on the basis of topographic or morphologic criteria.
authors.affiliation: Institution of Medical and Surgical Sciences, Department of Surgical Pathology, University Hospital of Padova, Padova, Italy.
authors.forename: Maria Rosa
authors.initials: MR
authors.lastname: Pelizzo
authors.forename: Andrea
authors.initials: A
authors.lastname: Losi
authors.forename: Isabella Merante
authors.initials: IM
authors.lastname: Boschin
authors.forename: Antonio
authors.initials: A
authors.lastname: Toniato
authors.forename: Gianmaria
authors.initials: G
authors.lastname: Pennelli
authors.forename: Nadia
authors.initials: N
authors.lastname: Sorgato
authors.forename: Diego
authors.initials: D
authors.lastname: Faggian
authors.forename: Mario
authors.initials: M
authors.lastname: Plebani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000737:chemistry* / Q000473:pathology*; D010281:Parathyroid Hormone / Q000032:analysis*; D016105:Parathyroidectomy; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013965:Thyroidectomy; D013997:Time Factors
chemical_list: D010281:Parathyroid Hormone