Ultrasonographic size of the canine parathyroid gland may not correlate with histopathology.

Accurate ultrasonographic differentiation of normal versus abnormal parathyroid glands is important for clinical workup and presurgical screening in dogs with hypercalcemia. In previous published studies, size has been the only ultrasonographic criterion correlated with histologic diagnoses of abnormal parathyroid glands. In this retrospective, cross-sectional study, the medical records of dogs with ultrasonographic examinations of the parathyroid glands and histologic diagnoses of parathyroid gland hyperplasia, adenoma, and adenocarcinoma were evaluated. Ultrasonographic characteristics were recorded for each gland and compared among histologic diagnosis groups. A total of 49 dogs and 59 parathyroid glands were sampled and assigned to the following groups for analyses: adenoma (n = 24), hyperplastic (n = 20), and adenocarcinoma (n = 15). There were no associations with dog age, sex, weight, breed; or gland laterality, location, ultrasonographic shape, or echogenicity among histologic diagnosis groups (P > .05). Parathyroid gland adenocarcinomas were found to be less likely to have a homogeneous echotexture on ultrasonographic evaluation, with hyperplastic glands being smaller (P = .022) and adenocarcinomas being larger (P = .042). While 3 mm was the optimum cutoff for differentiating hyperplastic and neoplastic parathyroid glands in this sample of dogs, values varied widely within groups and there were overlapping values between groups. Therefore, authors caution against using ultrasonographic size as a sole criterion for differentiating hyperplasia from neoplasia and normal versus abnormal parathyroid glands.

Disorders of the parathyroid glands.

The three calcitropic hormones, parathyroid hormone (PTH), 1,25-dihydroxycholecalciferol and calcitonin are together responsible for calcium homeostasis in the mammal. Feline PTH is an 84 amino acid, single chain polypeptide with a molecular weight of 9449, which is secreted by the parathyroid glands. The principle secretagogue for PTH is a low plasma ionised calcium concentration, although both 1,25-dihydroxycholecalciferol and phosphate have significant roles in regulating PTH secretion. The ability to accurately measure circulating PTH in the cat has simplified the evaluation of disorders of calcium metabolism in this species. In primary parathyroid disorders the lesion is located within the parathyroid gland, with parathyroid secretion being inappropriate to the prevailing mineral balance. By contrast, in secondary conditions a pathological state out with the parathyroid gland alters mineral homeostasis and the parathyroid gland responds in an appropriate manner. The measurement of circulating PTH may then be used to determine if PTH secretion is appropriate to the prevailing calcium concentrations to differentiate primary from secondary disorders. Although primary hyper and hypoparathyroidism are generally considered rare endocrine conditions of the cat, the ability to measure PTH has led to their increasing recognition.

Occurrence of the parathyroid cyst in golden hamsters.

Parathyroid cyst is a rare lesion, but has clinical significance because of it's ability to mimic a thyroid mass and it's association with hyperparathyroidism. The occurrence and morphology of parathyroid cysts in golden hamsters from neonatal to senile periods were investigated using light and electron microscopy. The results demonstrate the presence of chief cell cysts in the parathyroid glands of 5-day-old hamsters. Some chief cells lining the cyst wall showed mitosis and apoptosis. The existence of chief cell cysts may represent the rapid proliferation of the parathyroid chief cells in 5-day-old hamsters. Ciliated cysts were observed in the parathyroid glands of 5-day-, 1- and 3-month-old hamsters. Three cell types were distinguished in the wall of the ciliated cyst: Ciliated, mucous and basal cells. Ciliated cysts possessed the features of the pharyngeal epithelia without endocrine cells and may arise from embryological remnants of pharyngeal pouches in the neck undergoing cystic degeneration and entrapping portions of parathyroid tissue. The frequency of parathyroid cysts decreased with age.

Double-phase parathyroid scintigraphy in dogs using technetium-99M-sestamibi.

The purpose of this study was to evaluate the utility of double-phase parathyroid scintigraphy using 99mTc-sestamibi for detecting and localizing hyperfunctioning parathyroid glands in hypercalcemic dogs. Fifteen hypercalcemic dogs that underwent parathyroid scintigraphy were included in this study: 3 dogs with hypercalcemia of malignancy, and 12 dogs with hyperfunctioning parathyroid tissue (parathyroid adenoma or parathyroid hyperplasia). The presence of parathyroid adenoma or parathyroid hyperplasia was documented by histopathologic examination. In 3 dogs with hypercalcemia of malignancy, parathyroid scintigraphy was negative for hyperfunctioning parathyroid tissue and the scans were classified as true negative. Parathyroid scintigraphy correctly identified the presence and location of hyperfunctioning parathyroid tissue in only 1 of 6 dogs with a parathyroid adenoma. False positive and false negative results occurred in dogs with parathyroid adenomas. Parathyroid scintigraphy failed to detect hyperfunctioning parathyroid tissue in 5 of 6 dogs with parathyroid hyperplasia and were classified as false negative. False positive results were obtained in the remaining dog with parathyroid hyperplasia. Sensitivity of parathyroid scintigraphy for detecting and localizing hyperfunctioning parathyroid tissue was 11%, specificity was 50%, and overall accuracy was 27%. Positive and negative predictive value were 25% and 27%, respectively. Sensitivity for detection of parathyroid adenomas was 25%, and sensitivity for detection of hyperplastic glands was 0 %. Results of this study indicate that double-phase parathyroid scintigraphy does not appear to have acceptable accuracy in detecting hyperfunctioning parathyroid glands in dogs. Due to the poor sensitivity and specificity of the technique in dogs, parathyroid scintigraphy is not recommended for definitive identification of abnormal parathyroid glands as the cause of hypercalcemia in dogs.

Ultrasonography of the thyroid and parathyroid glands.

High-resolution thyroid and parathyroid ultrasonography can play an integral part in the diagnosis and management of patients with clinically undifferentiated cervical masses, thyroid carcinomas or adenomas, and primary parathyroid hyperplasia or neoplasia. Because the study is inexpensive, noninvasive, and easily performed, ultrasonography can be performed as a screening test early in the evaluation of a patient, and ultrasound findings can corroborate the results of other diagnostic procedures, leading to a more accurate diagnosis.