Safety And Diagnostic Performance Of Parathyroid Hormone Assay In Fine-Needle Aspirate In Suspicious Parathyroid Adenomas

Objective: To evaluate the safety and diagnostic performance of parathyroid hormone assay in fine-needle aspirate (PTH-FNA) in patients with primary hyperparathyroidism and suspicious parathyroid adenomas.Methodology: A retrospective observational study was performed in 47 patients (57.7 +/- 11.2 years of average age, 74% women) attending an endocrinology clinic for primary hyperparathyroidism (average calcemia: 11.6 +/- 1.6 mg/dl and PTH: 276 +/- 477 pg/ml) in which PTH-FNA was made. Sensibility, specificity, positive predictive value and negative predictive value were calculated in all surgical patients.Results: Forty-seven lesions were punctured (mean adenoma maximum diameter: 1.8 +/- 2.6 cm): negative image in the sestamibi scan (26 patients); the discordance between ultrasonography and the sestamibi scan (6 patients); possible intrathyroidal adenomas(4 patients); a positive sestamibi scan in 2 or more localizations (4 patients); ectopic adenoma(3 patients); persistent primary hyperparathyroidism (2 patients) and atypical adenomas (2 patients). Mean PTH-FNA was 2,853 +/- 3,957 pg/ml and 68% were considered positive (PTH-FNA >= 100 pg/ml). No complications were detected during or after the puncture. Thirty-seven patients were operated on, 95% were cured and no parathyromatosis cases were detected. PTH-FNA >= 100 pg/ml as a diagnostic test had a sensitivity of 93.7%, a specificity of 100%, a positive predictive value of 100% and an negative predictive value of 71.4%.Conclusion: PTH-FNA is an easy and safe diagnostic test and has a high sensitivity and specificity for differentiating between parathyroid adenomas and other cervical masses in patients with primary hyperparathyroidism. (C) 2020 SEEN y SED. Published by Elsevier Espana, S.L.U. All rights reserved.