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Parathyroid Pathology

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Medical and Surgical Treatment of Parathyroid Diseases

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Abstract

The purpose of cytohistologic evaluation is to guide surgical and clinical management. As such, understanding the basis for pathologic diagnosis as well as its limitations is crucial for interpretation of the diagnosis rendered. This chapter describes the conceptual categories into which parathyroid lesions are divided, reviews the histologic/cytologic criteria used to place lesions into specific categories and discusses the limitations of pathologic evaluation. In general, histologic evaluation is useful in segregating benign lesions from those which are worrisome or clearly malignant. However, distinctions between individual benign entities, particularly that between an asymmetric hyperplasia and an adenoma is less robust. Likewise, the distinction between atypical adenomas and carcinoma is poorly reproducible and does not correlate well with prognosis. These limitations reflect significant overlaps in the histologic features of these pairs of entities. Similarly, the cytologic distinction between parathyroid and thyroid tissue on fine needle aspiration is difficult and shows poor sensitivity and specificity, in part due to overlapping cytologic features and also misidentification of site of biopsy. Despite these limitations, correct cytologic identification can dramatically impact management and thus a high index of suspicion for parathyroid lesions is warranted as additional clinical studies can clarify the situation. By recognizing the strengths and weaknesses inherent in pathologic evaluation, the clinician can make better management decisions and aid the pathologist by providing pertinent clinical information.

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Authors and Affiliations

  1. Department of Pathology, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR, 72205, USA

    Chien Chen M.D., Ph.D.

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  1. Chien Chen M.D., Ph.D.
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Correspondence to Chien Chen M.D., Ph.D. .

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  1. Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

    Brendan C. Stack, Jr.

  2. Department of Geniatrics and Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

    Donald L. Bodenner

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Chen, C. (2017). Parathyroid Pathology. In: Stack, Jr., B., Bodenner, D. (eds) Medical and Surgical Treatment of Parathyroid Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-26794-4_30

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