Non-functioning Parathyroid Cysts: Diagnosis made by Needle Washout for PTH not Cytology.
Rossi ED et al Cytopathology 2015
1998-2012 at a single hospital there were 8 >2.5 cm parathyroid cysts. All were females. All had normal serum PTh and Calcium.
FNA cytology was inadequate for diagnosis with scanty cells. However, the clear fluid removed was tested for PTH and Thyroglobulin and the PTH was elevated confirmed it was parathyroid.
Comments: cytology can look like a microfollicular neoplasm or papillary cancer but the key is the washout test not the cytology.
Again all 8 had surgery. We would not treat pure parathyroid cyst with surgery when ethanol ablation PEI is highly successful and does not require surgery.
Richard Guttler MD,FACE,ECNU
Call Matt at 310-393-8860 if you have a thyroid or parathyroid cyst for evaluation for PEI without surgery