title: Fine needle cytology pre-surgical differentiation of parathyroid neoplasms: Is it reliable?
abstract: BACKGROUND
  Fine needle cytology (FNC) of a parathyroid neoplasia (PN) is reliable, but needs to be confirmed by Parathormone (PTH) and Thyroglobulin (TG) immunoassay on needle washing or by immunocytochemistry (ICC) evaluation. The differentiation between parathyroid adenoma (PA), atypical adenoma (PAA) and carcinoma (PC) is difficult on histology or even impossible on FNC. The aim of this study was to evaluate possible cytological criteria to classify FNC-PN further.
  
  
  METHODS
  Twenty-three FNC samples of PN and parathyroid cysts were rather then have been reviewed. The series includes 18 PNs, 4 cysts and 1 Thyr3B (histologically diagnosed as PA). Cytological features were: cellularity, patterns (follicular, solid or papillary), clear, oncocytic, isolated cells, nuclear atypia, cytoplasmic inclusions, nucleoli and mitoses. Data were compared with the histological controls.
  
  
  RESULTS
  Seventeen PNs, 2 cysts and 1 Thyr3B FNC samples were histologically diagnosed as PA (16), PAA (2) and PC (2). Two cysts and 1 PN were not confirmed histologically. Cytological features and incidences were: high cellularity (1 PA, 1 PAA, 2 PCs), follicular (8 PAs, 1 PAA), solid (5 PAs, 1 PC), papillary pattern (1PA, 1 PAA, 1 PC), clear cells (4 PAs, 1 PAA, 2 PCs), oncocytic cells (6 PAs, 1 PAA, 2 PCs), isolated cells (5 PAs, 2 PAAs, 2 PCs), nuclear atypia (2 PAs, 1 PAA, 2 PCs), cytoplasmic inclusions (4 PAs, 2 PCs), nucleoli (2 PCs) and mitoses (2 PCs).
  
  
  CONCLUSIONS
  Evident nucleoli and mitoses may suggest the differentiation between PA and PC. However, further investigations are required to confirm these preliminary observations.
authors.affiliation: Azienda Ospedaliera Universitaria "San Giovanni di Dio e Ruggi d' Aragona", Salerno, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Caleo
authors.affiliation: Azienda Ospedaliera Universitaria "San Giovanni di Dio e Ruggi d' Aragona", Salerno, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Vitale
authors.affiliation: Azienda Ospedaliera Universitaria "San Giovanni di Dio e Ruggi d' Aragona", Salerno, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Valvano
authors.affiliation: Azienda Ospedaliera Universitaria "San Giovanni di Dio e Ruggi d' Aragona", Salerno, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Siano
authors.affiliation: Azienda Ospedaliera Universitaria "San Giovanni di Dio e Ruggi d' Aragona", Salerno, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Angrisani
authors.affiliation: Azienda Ospedaliera Universitaria "San Giovanni di Dio e Ruggi d' Aragona", Salerno, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Forlenza
authors.affiliation: Azienda Ospedaliera Universitaria "San Giovanni di Dio e Ruggi d' Aragona", Salerno, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Massari
authors.affiliation: Azienda Ospedaliera Universitaria "San Giovanni di Dio e Ruggi d' Aragona", Salerno, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Puzziello
authors.affiliation: Azienda Ospedaliera Universitaria "San Giovanni di Dio e Ruggi d' Aragona", Salerno, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Salzano
authors.affiliation: Azienda Ospedaliera Universitaria "San Giovanni di Dio e Ruggi d' Aragona", Salerno, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Zeppa
mesh_terms: D044963:Biopsy, Fine-Needle; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000473:pathology*; D010282:Parathyroid Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*
keywords: fine needle cytology; parathyroid neoplasms