Intrathyroidal oxyphilic parathyroid carcinoma: A potential diagnostic caveat in cytology?

Wong Yin Ping, Noor Akmal Sharifah, Geok Chin Tan, Anthony James Gill, Syed Z. Ali

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Oxyphilic (oncocytic) parathyroid lesions are very uncommon and their cytological features are rarely described. Due to the similarities in anatomical location and indistinguishable cytomorphological features, these lesions are easily confused with neoplastic and non-neoplastic thyroid lesions on fine needle aspiration (FNA). The diagnosis becomes more challenging in cases of unusual intrathyroidal location of the parathyroid lesions in the absence of clinical evidence of hyperparathyroidism, which simulate thyroid nodules clinically. We describe a case of intrathyroidal oxyphilic parathyroid carcinoma in a 66-year-old female, who presented with a dominant left “thyroid” nodule. FNA smears were cellular, comprising predominantly of oxyphilic cells arranged in papillary-like architecture with occasional nuclear grooves, which was mistaken for oncocytic variant of papillary carcinoma of the thyroid. The histological diagnosis of oxyphilic parathyroid “adenoma” was made following total thyroidectomy. The tumor, unfortunately, recurred 7 years later with associated multiple lung metastases. When dealing with thyroid lesions comprising predominantly of oncocytic cells, one should consider oxyphilic parathyroid neoplasms as one of the differential diagnosis. In difficult equivocal cases, a panel of immunocytochemical stains (PTH, GATA3, TTF-1, PAX8, and thyroglobulin) can be helpful. In addition, a combination of valuable clinical, radiological, and laboratory data, including serum calcium and parathyroid hormone levels are key to arriving at an accurate cytological diagnosis. Diagn.

Original languageEnglish
Pages (from-to)688-692
Number of pages5
JournalDiagnostic Cytopathology
Volume44
Issue number8
DOIs
Publication statusPublished - 1 Aug 2016

Fingerprint

Parathyroid Neoplasms
Cell Biology
Thyroid Nodule
Fine Needle Biopsy
Thyroid Gland
Oxyphilic Adenoma
Hyperparathyroidism
Thyroglobulin
Thyroidectomy
Parathyroid Hormone
Differential Diagnosis
Coloring Agents
Neoplasm Metastasis
Calcium
Lung
Serum
Neoplasms

Keywords

  • cytology
  • diagnostic caveats
  • fine needle aspiration
  • oxyphilic
  • parathyroid carcinoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

Cite this

Intrathyroidal oxyphilic parathyroid carcinoma : A potential diagnostic caveat in cytology? / Yin Ping, Wong; Sharifah, Noor Akmal; Tan, Geok Chin; Gill, Anthony James; Ali, Syed Z.

In: Diagnostic Cytopathology, Vol. 44, No. 8, 01.08.2016, p. 688-692.

Research output: Contribution to journalArticle

Yin Ping, Wong ; Sharifah, Noor Akmal ; Tan, Geok Chin ; Gill, Anthony James ; Ali, Syed Z. / Intrathyroidal oxyphilic parathyroid carcinoma : A potential diagnostic caveat in cytology?. In: Diagnostic Cytopathology. 2016 ; Vol. 44, No. 8. pp. 688-692.
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