Biopsy, Fine-Needle ; Cytodiagnosis ; Humans ; Parathyroid Glands ; pathology

Concurrent thyroid carcinoma and parathyroid adenoma is rare, they can and do coexist. We present here a 63-year old man who had bilateral papillary thyroid carcinoma and a parathyroid adenoma in the right thyroid lobe. Thyroid cancer was confirmed surgically. After the operation, the patient was found hypercalcemie and hypophosphatemia along with an elevated parathyroid hormone (PTH), indicating primary hyperparathyroidism. Also, the parathyroid 99mTc-MIBI scan demonstrated parathyroid adenoma in the right lower pole of the thyroid. The abnormal parathyroid tissue was carried out, and then serum calcium and PTH levels decreased to normal ranges.
Calcium ; blood ; Carcinoma ; pathology ; surgery ; Carcinoma, Papillary ; Humans ; Hyperparathyroidism, Primary ; Male ; Middle Aged ; Parathyroid Glands ; pathology ; Parathyroid Hormone ; blood ; Parathyroid Neoplasms ; pathology ; surgery ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; pathology ; surgery

OBJECTIVE: To compare the diagnostic value among the single photon emission computed tomography/computerized tomography (SPECT/CT), (99m)Tc-sestamibi (MIBI) planar scintigraphy, ultrasonography (US) and computerized tomography (CT) in diagnosis of patients with hyperparathyroidism (HPT).
 METHODS: A total of 59 patients were retrospectively recruited for this study. The patients received parathyroidectomy and were verified by pathological examination. Among them, 31, 28 and 26 patients received SPECT/CT, (99m)Tc-MIBI planar scintigraphy, US and CT, respectively, before the parathyroidectomy. The sensitivity for localization or qualitation was compared between SPECT/CT and (99m)Tc-MIBI planar scintigraphy; the sensitivity, specificity and accuracy were compared among the SPECT/CT, (99m)Tc-MIBI planar scintigraphy, US and CT.
 RESULTS: There was no statistical difference in the sensitivity of localization between SPECT/CT and (99m)Tc-MIBI planar scintigraphy (P>0.05); however, the SPECT/CT exhibited more sensitive than the (99m)Tc-MIBI planar scintigraphy in detection of hyperplastic lesions (P<0.05). Among the four imaging modalities, SPECT/CT had advantages over (99m)Tc-MIBI planar scintigraphy in terms of accuracy (P<0.05). In contrast, the sensitivity of CT was not as good as that of SPECT/CT and US (both P<0.05). For the diagnosis of lesions with a diameter more than 1 cm, the sensitivity of SPECT/CT was the best (all P<0.05). However, the sensitivity of US was the best in diagnosis of lesions with a diameter less than 1 cm (all P<0.05).
 CONCLUSION The SPECT/CT is more effective than (99m)Tc-MIBI planar scintigraphy in diagnosis of HPT, especially in diagnosis of hyperplastic lesions. Both of SPECT/CT and US are recommended to localize the target parathyroid lesions of HPT before the parathyroidectomy.
Humans ; Hyperparathyroidism ; diagnosis ; diagnostic imaging ; Hyperplasia ; Parathyroid Glands ; diagnostic imaging ; pathology ; Parathyroidectomy ; Radionuclide Imaging ; Retrospective Studies ; Sensitivity and Specificity ; Technetium Tc 99m Sestamibi ; Tomography, Emission-Computed, Single-Photon ; Tomography, X-Ray Computed ; Ultrasonography

A 56 years old female was admitted to our department with complaint of a painless cervical mass. Clinical feature:there was a painless mass above left lobe of thyroid gland, which was about 3.0 cm x 2.5 cm in size, and could move with swallowing action. B-mode ultrasound features: there was a solid mass in left lobe of thyroid gland, which was about 3.2 cm. Nodule was found in isthmus, accompanied with lymphadenovarix on the left neck possibly be MCA. fT3: 4.64 pmol/L, fT4:16.56 pmol/L,TSH:3.74 mIU/L, anti-TG:17.75 U/ml, anti-TPO:40.77 U/ml. Pathological result of the neoplasm: papillocarcinoma. Clinical diagnosis: papillary thyroid carcinoma.
Carcinoma ; diagnosis ; pathology ; Carcinoma, Papillary ; diagnosis ; pathology ; Deglutition ; Female ; Humans ; Middle Aged ; Neck ; pathology ; Parathyroid Glands ; pathology ; Recurrent Laryngeal Nerve ; pathology ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; diagnosis ; pathology

Adult ; Histiocytosis, Langerhans-Cell ; diagnosis ; Humans ; Male ; Pancreas ; pathology ; Parathyroid Glands ; pathology

OBJECTIVE: The purpose of this study was to discuss the role of the combination of carbon nanoparticles and medical imaging to manage the cervical lymph nodes in patients with thyroid carcinoma. METHOD: Eighty one patients with thyroid carcinoma that primary treated were divided into two groups: trial group and control group. Carbon nanoparticles were injected into the thyroid gland of trial group patients. Central compartment (level VI) dissection, levels IIl and IV dissection, lateral node (levels II-V) dissection were performed respectively in all the patients on the basis of medical imaging and pathology. Total lymph nodes, metastasis lymph nodes, black stained lymph nodes and black stained metastasis lymph nodes of trial group were counted respectively in different dissection specimens. Total lymph nodes and metastasis lymph nodes of control group were counted respectively in different dissection specimens. Parathyroid glands of thyroid or central compartment dissection specimens were counted in two groups. RESULT: In trial group, rate of staining lymph node was 80.0% in central neck dissection tissue, 54.9% in levels III and IV dissection specimen, 39.1% in lateral node dissection specimen. In central compartment dissection tissue, lymph nodes on average in control group were less than in trial group (3.03 ± 2.07 vs. 4.72 ± 2.97) (P < 0.01). The same was in levels III and lV dissection specimen (5.53 ± 3.78 vs. 10.29 ± 3.36) (P < 0.01). As for lateral node dissection specimen,there was no statistic difference in the two group (13.4 ± 9.67 vs. 14.56 ± 6.28) (P > 0.05). There was no statistic difference between control group and trial group for the metastasis lymph nodes in difference dissection specimens. Parathyroid gland was found in 3 thyroid or central compartment dissection specimens among trial group, which was found in 9 specimens among control group, the difference had statistical significance (P < 0.05). CONCLUSION During levels III and IV dissection in cN0 patients or central compartment dissection, lymph nodes can be signed well by carbon nanoparticles, which can improve the lymph node detection rate, but can not increase the lymph node detection rate in cN+ patients. Parathyroid gland can be preserved by carbon nanoparticles during the thyroid gland resection and central neck dissection.
Carbon ; administration & dosage ; Diagnostic Imaging ; methods ; Female ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Male ; Nanoparticles ; administration & dosage ; Neck ; Neck Dissection ; methods ; Parathyroid Glands ; Staining and Labeling ; Thyroid Neoplasms ; diagnosis ; pathology ; Thyroidectomy

OBJECTIVE: To investigate the clinical feature,diagnostic and therapeutic methods of ultimobranchial fistula and cyst of thyroid. METHOD: Four cases of ultimobranchial fistula and cyst of thyroid in our hospital were reported and the relevant literatures were reviewed. RESULT: The branchial fistula and cyst of four cases were adhered to thyroid,with unclear anatomical landmarks, the function of recurrent laryngeal nerve were bad before the operation in two cases. The nerve of four cases were retained, the function of thyriod and parathyroid gland were normal and no recurrence were found. CONCLUSION Ultimobranchial fistula and cyst of thyroid is rare and is easier to be misdiagnosed and wrong treated. Surgical excision is effective for it and recurrent laryngeal nerve should be protected when performing the operation.
Cysts ; Diagnostic Errors ; Fistula ; Humans ; Parathyroid Glands ; Recurrent Laryngeal Nerve ; Thyroid Diseases ; pathology ; surgery

OBJECTIVE: To discuss the role of carbon nanoparticles in the protection of parathyroid during thyroid carcinoma surgery. METHOD: Seventy-two patients with thyroid carcinoma who had initial surgery were randomly divided into two groups: carbon nanoparticles group and the control group. Emulsion of carbon nanoparticles was injected into the thyroid gland of carbon nanoparticles group patients. After thirty minutes,the excision of thyroid carcinoma and VI group neck dissection were performed in carbon nanoparticles group patients, the control group directly underwent operation. The black stained tissue in the dissection specimen of carbon nanoparticles group was separated. The number of total lymph node,metastasis lymph node and parathyroid gland in the tissure black stained or not in two groups were counted respectively. RESULTS: There were 312 lymph nodes in the black stained tissue of central compartment dissection specimen of carbon nanoparticles group. No parathyroid gland was found in the black stained tissue. Fifteen lymph nodes containing four parathyroid glands were found in the non black stained tissue in carbon nanoparticles group while there were 202 lymph nodes containing 13 parathyroid glands in the control group. There were statistical difference between the amount of lymph node in black stain tissue and the specimen of the control group. Parathyroid glands were not stained black,and no parathyroid gland was found in the black-stained tissue. CONCLUSION The carbon nanoparticles could be used to identify the lymph node and the parathyroid gland for protecting the parathyroid gland in thyroid surgery.
Carbon ; Carcinoma ; Coloring Agents ; Dissection ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Nanoparticles ; Neck Dissection ; Parathyroid Glands ; Thyroid Neoplasms ; pathology ; surgery

Multiple endocrine neoplasia type 1 (MEN1) syndrome includes varying combinations of endocrine and non-endocrine tumors. There are also a considerable number of atypical MEN1 syndrome. In this case, a 68-yr-old woman was referred to the Department of Endocrinology for hypercalcemia. Five years ago, she had diagnosed as primary hyperaldosteronism and now newly diagnosed as parathyroid hyperplasia with laboratory and pathologic findings. Hurthle-cell thyroid cancer was also resected during the parathyroid exploration and small meningioma was found on brain MRI. Her general condition has markedly improved and her adrenal mass and meningioma are being closely observed now. We could find the loss of heterozygosity of the MEN1 locus in parathyroid glands, suggesting a MEN1-related tumor, but not a germline mutation. Considering a variety of phenotypic expression and a limitation of current molecular analysis, periodic follow up will be needed in patients with a MEN1-like phenotype.
Aged ; Base Sequence ; Brain/radionuclide imaging ; Female ; Humans ; Hyperaldosteronism/complications/*diagnosis ; Hyperparathyroidism, Primary/*diagnosis/etiology/pathology ; Loss of Heterozygosity ; Magnetic Resonance Imaging ; Meningeal Neoplasms/complications/*diagnosis/radionuclide imaging ; Meningioma/complications/*diagnosis/radionuclide imaging ; Mutation ; Parathyroid Glands/pathology ; Proto-Oncogene Proteins/genetics/metabolism ; Sequence Analysis, DNA ; Thyroid Neoplasms/complications/*diagnosis/pathology ; Tomography, X-Ray Computed

OBJECTIVETo investigate clinicopathological features of DiGeorge syndrome (DGS).

METHODThe clinical features, histological and immunohistochemical findings were analyzed in 5 cases of DGS by autopsy.

RESULTSFive cases of DGS in male infants aged 4 days, 1 month, 7 months, 10 months, and 13 months respectively. Gross and microscopic observations revealed that thymic cortex was depleted of lymphocytes or showed few, dispersed lymphocytes. The thymic medulla showed predominantly epithelial cells with calcified Hassall bodies as well as lymphocyte depletion. T lymphocytes were also scarce in the tonsils, lymph nodes, spleen, and mucosa-associated lymphatic tissue of ileum. In addition, 3 of the 5 patients also showed parathyroid aplasia or dysplasia, and congenital hypertrophy of the ventricular septum.

CONCLUSIONSThe pathological changes indicate that clinicians should be aware of defects of immune system if the infants suffer from severe infections. Pathologists should recognize the importance of abnormalities of lymphohematopoietic tissues in the diagnosis of primary immunodeficiency diseases such as DGS.

Autopsy ; DiGeorge Syndrome ; immunology ; pathology ; virology ; Hepatitis, Viral, Human ; pathology ; Humans ; Hypertrophy, Left Ventricular ; pathology ; Infant ; Infant, Newborn ; Lymphocyte Count ; Male ; Parathyroid Glands ; pathology ; Pneumonia, Viral ; pathology ; T-Lymphocytes ; immunology ; pathology ; Thymus Gland ; pathology