Agarwal Gaurav, Dhingra Sadhna, Mishra Saroj K, Krishnani Narendra
Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India.
Langenbecks Arch Surg. 2006 Nov;391(6):623-6. doi: 10.1007/s00423-006-0095-8. Epub 2006 Oct 5.
Fine needle aspiration cytology is not a commonly employed diagnostic modality in the diagnosis of parathyroid tumors.
A 28 year old lady being followed-up for 5 years after en bloc resection of a parathyroid carcinoma presented with a nodule in the lower neck, away from the parathyroidectomy scar. The 1 cm isolated nodule was located in the muscular and subcutaneous plane and corresponded to the needle track of FNA performed on a neck nodule before the parathyroidectomy. On evaluation, she had mild hypercalcemia and high normal serum parathyroid hormone levels. FNAC and histology including immunohistochemistry for Chromogranin A after local excision of the nodule confirmed the nodule to be a recurrent parathyroid carcinoma along the needle track.
To the best of the authors' knowledge, this is only the second case of needle track implantation after FNA in parathyroid carcinoma reported to date. This case highlights the risk of engraftment of parathyroid tissue after FNA and cautions against the use of FNA as a preoperative diagnostic modality for the evaluation of parathyroid lesions.
细针穿刺细胞学检查在甲状旁腺肿瘤的诊断中并非常用的诊断方法。
一名28岁女性在甲状旁腺癌整块切除术后接受了5年随访，现于颈部下方出现一个结节，该结节远离甲状旁腺切除术瘢痕。这个1厘米的孤立结节位于肌肉和皮下平面，与甲状旁腺切除术之前对颈部一个结节进行细针穿刺活检的针道相对应。经评估，她有轻度高钙血症且血清甲状旁腺激素水平略高于正常范围。在对该结节进行局部切除后，细针穿刺活检及组织学检查（包括嗜铬粒蛋白A免疫组化）证实该结节是沿针道复发的甲状旁腺癌。
据作者所知，这是迄今为止报道的第二例甲状旁腺癌细针穿刺活检后针道种植的病例。该病例凸显了细针穿刺活检后甲状旁腺组织植入的风险，并警示不要将细针穿刺活检用作评估甲状旁腺病变的术前诊断方法。
