Fujimoto Tomoko, Hirokawa Mitsuyoshi, Suzuki Ayana, Oshita Maki, Yamaoka Hiroyuki, Fujishima Makoto, Onoda Naoyoshi, Miyauchi Akira, Akamizu Takashi
Department of Clinical Laboratory, Kuma Hospital, 8-2-35 Shimoyamate-Dori, Chuo-Ku, Kobe, Hyogo, 650-0011, Japan.
Department of Diagnostic Pathology and Cytology, Kuma Hospital, Kobe, Hyogo, 650-0011, Japan.
J Med Ultrason (2001). 2025 Apr;52(2):237-243. doi: 10.1007/s10396-024-01511-2. Epub 2024 Dec 28.
Parathyroid lipoadenomas are difficult to recognize preoperatively; hence, they may remain undetected. Difficulty in recognition is thought to be due to the adipocytes present in the tumor. This study aimed to clarify the impact of adipocytes as a component of parathyroid adenomas on ultrasound evaluation.
Eighteen parathyroid adenoma cases, in which the adipose tissue accounted for more than 10% of the tumors, were included in this study. Of these, five were consistent with lipoadenomas. Twenty-five consecutive patients with parathyroid adenoma without adipocytes were used as controls.
Ultrasonography revealed a lipoadenoma detection rate of 20.0%. This increased to 80.0% at re-examinations performed after obtaining information from other imaging modalities. Compared with parathyroid adenoma cases with no adipocytes or few adipocytes, the frequencies of ill-defined margins, iso- and/or hyperechogenicity, heterogeneous consistency with a two-tone pattern, poor vascular flow, no polar artery, and no hyperechoic line were significantly higher in parathyroid lipoadenoma cases. The hyperechoic and isoechoic areas in tumors with a two-tone pattern correspond to adipocyte- and parathyroid cell-rich areas, respectively. The lipoadenoma tumor sizes measured using ultrasound tended to be smaller than the actual sizes.
The characteristic ultrasound findings of lipoadenomas were clearly different from those of parathyroid adenomas with or without adipocytes. We believe that our findings may contribute to an increased detection rate of lipoadenomas and allow us to consider them in the differential diagnosis.
甲状旁腺脂肪瘤术前难以识别，因此可能未被发现。识别困难被认为是由于肿瘤中存在脂肪细胞。本研究旨在阐明脂肪细胞作为甲状旁腺腺瘤的一个组成部分对超声评估的影响。
本研究纳入了18例甲状旁腺腺瘤病例，其中脂肪组织占肿瘤的10%以上。其中5例符合脂肪瘤诊断。连续选取25例无脂肪细胞的甲状旁腺腺瘤患者作为对照。
超声检查显示脂肪瘤的检出率为20.0%。在从其他影像学检查获得信息后进行的复查中，这一比例增至80.0%。与无脂肪细胞或脂肪细胞较少的甲状旁腺腺瘤病例相比，甲状旁腺脂肪瘤病例中边界不清、等回声和/或高回声、呈双色调模式的不均匀质地、血流差、无极动脉以及无高回声线的频率明显更高。双色调模式肿瘤中的高回声区和等回声区分别对应富含脂肪细胞和甲状旁腺细胞的区域。超声测量的脂肪瘤大小往往小于实际大小。
脂肪瘤的特征性超声表现与有无脂肪细胞的甲状旁腺腺瘤明显不同。我们认为我们的研究结果可能有助于提高脂肪瘤的检出率，并使我们能够在鉴别诊断中考虑到它们。
