Endoscopic Ultrasound-Guided Fine-Needle Aspiration With Aspirate Assay to Diagnose Suspected Mediastinal Parathyroid Adenomas

Vu, Duc Huy; Erickson, Richard A.

doi:10.4158/ep09220.cr

Cited by 10 publications

(4 citation statements)

References 23 publications

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“…[24] Additionally, for example, parathyroid hormone concentration measurement in the aspirated material in cases of suspected mediastinal parathyroid adenomas may make EUS-FNA a useful adjunct in diagnosing mediastinal parathyroid adenomas. [25]…”

Section: Discussionmentioning

confidence: 99%

Combined use of EUS-guided FNA and immunocytochemical stains discloses metastatic and unusual diseases in the evaluation of mediastinal lymphadenopathy of unknown etiology

Eloubeidi¹,

Khan²,

Luz³

et al. 2012

Ann Thorac Med

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PURPOSE:Mediastinal lymphadenopathy (ML) is a cause for concern, especially in patients with previous malignancy. We report our experience with the use of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) with immunocytochemical stains in patients being evaluated for ML.METHODS:Retrospective analysis of patients with ML of unknown origin who underwent EUS-FNA. On-site evaluation was performed by experienced cytologist, and special immunocytochemical stains were requested as indicated.RESULTS:A total of 116 patients were included, and a total of 136 mediastinal LN were sampled. Prior malignancy was present in 45%. The most common site of examined lymph node (LN) were subcarinal (76%, 103 LN). The median long and short axis diameters were 28 mm and 13 mm, respectively. FNA was read on-site as malignant, 21 (16%); benign, 100 (76.9%); suspicious, six (4%); atypical, 3 (2%); and inadequate sample, six (4%). Sixty-four LN were deferred for additional studies; 22 for immunocytochemical and 26 for Gimesa (GMS) stain and 21 for flow cytometry. Final FNA read was malignant in 28 (21%), benign in 103 (76%), suspicious in three (2%), and atypical in two (1%). Metastatic malignancies disclosed included Hodgkin's and Non-Hodgkin's lymphoma, melanoma, hepatoma, breast, lung, colon, renal, endometrial, Fallopian tube, and unknown carcinoma. The sensitivity, specificity, and accuracy of the final FNA read to predict malignancy were 100%.CONCLUSION:EUS-guided FNA with additional ancillary studies is useful in disclosing metastatic ML from a variety of neoplasms. Due to its safety and accuracy profile, it should be considered the test of choice in evaluating abnormal ML in appropriately selected patients.

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Section: Discussionmentioning

confidence: 99%

Combined use of EUS-guided FNA and immunocytochemical stains discloses metastatic and unusual diseases in the evaluation of mediastinal lymphadenopathy of unknown etiology

Eloubeidi¹,

Khan²,

Luz³

et al. 2012

Ann Thorac Med

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“…FNA biopsy is seldom used in evaluation of parathyroid lesions, especially those that can be visualized by ultrasound. Some authors suggested that FNA is valuable in patients who have a nondiagnostic Tc 99 -sestamibi scan, with multiple enlarged parathyroid glands, prior failed surgery, differentiating parathyroid adenomas from posterior thyroid nodules, atypical location, and nonfunctioning parathyroid incidentalomas (Abraham, Duick et al 2008;Vu and Erickson 2010). Cellular FNA specimens with features not typical for thyroid lesions should be triaged for PTH assay in the FNA rinse, which is useful to differentiate parathyroid lesions from thyroid lesions (Owens, Rekhtman et al 2008;Ciuni, Ciuni et al 2010;Lieu 2010).…”

Section: Clinical Workup Of Parathyroid Lesionsmentioning

confidence: 99%

Contemporary Aspects of Endocrinology

Diamanti-Kandarakis¹

2011

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She received her MD from Medical School of Athens and her PhD in experimental Endocrinology on the effects of androgens in hypophysectomised rats, from the same University. Dr Diamanti-Kandarakis completed her initial training in internal medicine in England before continuing in the United States. For the past 15 years, her research interests have been focused on clinical, molecular and environmental aspects of metabolic and hormonal abnormalities in Polycystic ovarian syndrome. This work has generated more than 120 publications and more than 3,500 citations. Dr Diamanti-Kandarakis has been invited by the international academic community as a speaker and has given more than 100 lectures, in Europe, Asia, Africa, North and South America. ContentsPreface XIII Part Introduction to Endocrinology 1 Chapter The Power of an Evolutionary Perspective in Studies of Endocrinology 3 Jing He, David M. Irwin and Ya-Ping Zhang X Preface  «Acromegaly and Gigantism» by Dr. Akin Fulya et al.; authors attempt to provide data concerning the history, epidemiology, etiology, pathophysiology, clinical features, diagnosis and treatment of acromegaly.  «Effects of Growth hormone (GH) over-expression on signaling cascades involved in promotion of cell proliferation and survival» by Dr. González Lorena et al.; authors analyze the effects of long term exposure to growth hormone (GH) at the molecular level in the liver. III. THE THYROID GLAND including the following chapters:  «Negative regulation of the thyrotropin beta gene by T3» by Dr. Sasaki Shigekazu et al.; an up-to-date review focused on the molecular mechanisms of negative regulation of the TSH beta gene by T3.  «Clinical management of thyroid nodules in the areas of various iodine supply» by Prof. Słowińska-Klencka Dorota et al.; a review is focused on the clinical management of thyroid nodules in areas of different iodine status (high, sufficient or inadequate iodine supply).  «Clinical Workup of Nodular and Mass Lesions of the Endocrine Organs» by Dr. Lin Xiaoqi et al.; a review focused on the application of FNA biopsy for thyroid and parathyroid lessions.  «Molecular biology of thyroid cancer» by Prof. Viglietto Giuseppe et al.; a revision on thyroid tumorigenesis covering a wide literature spectrum from epidemiology and risk factors of thyroid cancer to the mechanisms and molecular pathways that underlie onset and progression of these neoplasms.  «Diagnosis and differential diagnosis of medullary thyroid cancer» by Dr. Faggiano Antongiulio et al.; a review focused on the pathogenesis, diagnosis and therapeutic approach of medullary thyroid cancer.  «Molecular Diagnostics in Treatment of Medullary Thyroid Carcinoma» by Prof. Pützer Brigitte et al.; a review focused on new perspectives in the molecular diagnostic approach of patients with medullary thyroid cancer.  «Medullary thyroid carcinoma associated with RET mutations located in exon» by Dr. Peppa Melpomeni et al.; a chapter focused on the genetic analysis of the RET protooncogene -apart from the known somatic mutat...

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“…[2,3] Endoscopic ultrasound (EUS) localization and fine-needle aspiration (FNA) of suspected PTA to assess parathyroid hormone (PTH) are reported in literature. [4,5] We report a case where EUS-FNA confirmed PTA causing hyperparathyroidism and pancreatitis. For reprints contact: reprints@medknow.com pancreatitis without prior history of biliary colic/trauma.…”

Section: Introductionmentioning

confidence: 96%