Muthukrishnan J, Verma A, Modi K D, Kumaresan K, Jha Sangeeta
Department of Endocrinology, Medwin Hospital, Hyderabad.
J Assoc Physicians India. 2007 Jul;55:515-8.
Primary Hyperparathyroidism is known to present with protean manifestations leading to misdiagnosis in the initial stages of the disease. Inability to locate the adenoma in an ectopic parathyroid gland may further delay the diagnosis of these cases. Aberrant migration during development may lead to intrathyroidal or other ectopic locations of parathyroid glands. This may lead to their misdiagnosis as a thyroid nodule or failure to locate parathyroids during surgery. Similarity in cytological picture between thyroids and parathyroids may further complicate diagnosis by fine needle aspiration cytology. Nuclear imaging scintigraphy accurately localizes the tumor in 90% of cases and simplifies the surgical management. We encountered three such cases with the parathyroid gland adenomas in ectopic locations in which pre-operative nuclear imaging played a major role.
原发性甲状旁腺功能亢进症以多种表现形式出现，在疾病初期易导致误诊。无法在异位甲状旁腺中定位腺瘤可能会进一步延迟这些病例的诊断。发育过程中的异常迁移可能导致甲状旁腺位于甲状腺内或其他异位位置。这可能导致它们被误诊为甲状腺结节或在手术中无法找到甲状旁腺。甲状腺和甲状旁腺在细胞学图像上的相似性可能会使细针穿刺细胞学诊断更加复杂。核成像闪烁扫描在90%的病例中能准确地定位肿瘤，简化了手术管理。我们遇到了三例甲状旁腺腺瘤位于异位位置的病例，术前核成像在其中发挥了重要作用。
