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Parathyroid gland

General

Parathyroid cysts

Reviewer: Monika Roychowdhury, M.D. (see Reviewers page)
Revised: 16 February 2013, last major update January 2013
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● Patients usually are normocalcemic and present with an asymptomatic mass
● May be hyperplastic gland (Am J Clin Pathol 1982;77:104), adenoma with cystic degeneration, heterotopic salivary gland like tissue (Am J Surg Pathol 2000;24:837)
● Can diagnose by FNA if PTH in fluid (Am J Clin Pathol 1986;86:776)
● Cystic parathyroid lesions often contain turbid or colored fluid
● Functional parathyroid cysts more common than nonfunctional parathyroid cysts (Arch Surg 2009;144:52)
● During resection, cyst rupture should be avoided, and patients with large cysts should be managed expectantly to forestall the development of symptomatic hypocalcemia

Case reports
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● 50 year old woman with cystic cervical lesion (Med Ultrason 2011;13:157)
● 58 year old woman with rare case of malignant hypercalcemia (Case Report Med 2012;2012:851941)

Treatment
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● Simple aspiration to diagnosis and treat, ethanol ablation for recurrent cases (Eur J Radiol 2013;82:316)

Gross description
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● Usually large, in inferior glands
● Unilocular, thin walled with clear fluid containing PTH

Micro description
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● Lined by flattened parathyroid epithelium without nodules
● May contain granular material resembling colloid

Micro images
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Fibroadipose tissue containing islands of parathyroid tissue

Positive stains
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● Chromogranin A, glycogen, PTH

Negative stains
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● Thyroglobulin

End of Parathyroid gland > General > Parathyroid cysts

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