Journal of Pathology and Translational Medicine

Case Reports

Functioning Parathyroid Carcinoma: A case report.: Kyoung Chan Choi, Won Hee Choi; Korean J Pathol. 1996;30(2):169-172.

Abstract PDF: Parathyroid carcinoma is a relatively rare endocrine tumor, accounting for approximately 1 to 5% of patients with primary hyperparathyroidism. Patients with parathyroid carcinomas are often symptomatic, have markedly elevated calcium levels, and have a palpable cervical mass. They are equally distributed between the sexes and usually present 10 years before their benign counterparts. The diagnosis is suspected when the tumor is large, parathyroid hormone levels are high, and a palpable mass is present in the neck. Parathyroid carcinoma is often misdiagnosed preoperatively, suspected intraoperatively, and only confirmed postoperatively. We experienced a case of hyperfunctioning parathyroid carcinoma in a 36 year old man, which was confirmed microscopically. The tumor showed: 1) capsular and blood vessel invasion; 2) frequent mitotic figures in the parenchymal cells; 3) a trabecular pattern, and 4) intervening thick fibrous bands. Immunohistochemical stain of p53 may be one of the useful methods in identifying malignancy of parathyroid gland.

Fine Needle Aspiration Cytology of Parathyroid Neoplasms: A Review of Three Cases.: Lucia Kim, Jee Young Han, In Suh Park, Suk Jin Choi, Joon Mee Kim, Young Chae Chu; Korean J Cytopathol. 2007;18(1):74-80.

Abstract PDF: Parathyroid tumors may be difficult to distinguish from thyroid follicular lesions, especially when a tumor is nonfunctioning. We report here two cases of asymptomatic parathyroid carcinoma preoperatively misdiagnosed as thyroid follicular lesions, and one case of parathyroid adenoma showing hyperparathyroidism, and review the cytologic features favoring the diagnosis of parathyroid neoplasm. The cytologic findings that are characterized by clean background, monomorphic small cells, cohesive three-dimensional papillary clusters, small tight clusters with scattered naked nuclei, and well-defined clear cytoplasm favor a diagnosis for the parathyroid lesions. Cytologic findings such as macrofollicular structure, presence of colloid and macrophages, and presence of perivacuolar cytoplasmic granules on May-Grunwald-Giemsa stain support a diagnosis of a thyroid follicular lesion. The cytomorphology of parathyroid tumors is so variable that the distinction from a thyroid lesion cannot be based on the presence or absence of a single feature only but on the cytologic features as a whole.

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