{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T11:12:02Z","timestamp":1760267522567},"reference-count":28,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,2,22]],"date-time":"2018-02-22T00:00:00Z","timestamp":1519257600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2018,2,22]],"date-time":"2018-02-22T00:00:00Z","timestamp":1519257600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"funder":[{"name":"William and Susan Johnson Thyroid Tissue Bank at the University of Pittsburgh"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Parathyroid glands can mimic thyroid follicular lesions on fine\u2010needle aspiration (FNA) cytology and can lead to unnecessary or incorrect surgery. Newer molecular panel tests using next\u2010generation sequencing (NGS) include analysis of cell type\u2010specific gene expression profiles such as parathyroid. The study aim is to determine the frequency and clinical implications of parathyroid tissue identification by molecular testing in cytologically indeterminate \u201cthyroid\u201d lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Molecular analysis of indeterminate thyroid FNA specimens is obtained routinely and relies on amplification\u2010based NGS inclusive of PTH\u2010specific expression profiles. For this study, we retrospectively examined the clinical data and management of patients with molecular results positive for PTH expression from May 2014 until May 2016.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 4765 consecutive patients with indeterminate cytology for a presumed thyroid nodule, NGS instead indicated a parathyroid lesion in 20 patients (0.42%). The clinical data of 15 patients were available, and the subsequent clinical management was altered in 93% (14\/15 patients), including five (33%) eucalcemic patients who could avoid unnecessary surgery. Primary hyperparathyroidism was not suspected in seven patients until the molecular analysis results, and primary hyperparathyroidism was diagnosed in one (14%). During parathyroid exploration, most patients (6\/8, 75%) required concurrent thyroidectomy or lobectomy, but thyroid preservation was still possible in two patients. A parathyroid gland was histologically confirmed in 89%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In 0.42% of patients with indeterminate cytology results, next\u2010generation molecular results will indicate the presence of a parathyroid lesion. When this occurs, it is accurate and can robustly impact clinical management (93%).<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-018-4548-3","type":"journal-article","created":{"date-parts":[[2018,2,23]],"date-time":"2018-02-23T18:53:07Z","timestamp":1519411987000},"page":"2840-2845","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Incidental Diagnosis of Parathyroid Lesions by Preoperative Use of Next\u2010Generation Molecular Testing"],"prefix":"10.1002","volume":"42","author":[{"given":"Wu","family":"Bo","sequence":"first","affiliation":[{"name":"Division of Endocrine Surgery University of Pittsburgh 3471 Fifth Ave, Kauffman Bldg, Ste 101 15213 Pittsburgh PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen E.","family":"Schoedel","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Pittsburgh School of Medicine Pittsburgh PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sally E.","family":"Carty","sequence":"additional","affiliation":[{"name":"Division of Endocrine Surgery University of Pittsburgh 3471 Fifth Ave, Kauffman Bldg, Ste 101 15213 Pittsburgh PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa A.","family":"Radkay","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Pittsburgh School of Medicine Pittsburgh PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N. Paul","family":"Ohori","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Pittsburgh School of Medicine Pittsburgh PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuri E.","family":"Nikiforov","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Pittsburgh School of Medicine Pittsburgh PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina N.","family":"Nikiforova","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Pittsburgh School of Medicine Pittsburgh PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linwah","family":"Yip","sequence":"additional","affiliation":[{"name":"Division of Endocrine Surgery University of Pittsburgh 3471 Fifth Ave, Kauffman Bldg, Ste 101 15213 Pittsburgh PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,2,22]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0020"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000000875"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2015.11.045"},{"key":"e_1_2_7_5_2","first-page":"743","article-title":"Parathyroid incidentalomas detected on routine ultrasound\u2010directed fine\u2010needle aspiration biopsy in patients referred for thyroid nodules and the role of parathyroid hormone analysis in the samples","volume":"19","author":"Kwak JY","year":"2009","journal-title":"Thyroid"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/dc.23508"},{"key":"e_1_2_7_7_2","first-page":"3","article-title":"Ultrasound guided fine needle aspiration biopsy of parathyroid gland and lesions","volume":"28","author":"Dimashkieh H","year":"2006","journal-title":"Cytojournal"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/hed.10003"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2009.0274"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011\u20101469"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.29038"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0305"},{"key":"e_1_2_7_13_2","first-page":"1","article-title":"Distinguishing parathyroid and thyroid lesions on ultrasound\u2010guided fine\u2010needle aspiration: a correlation of clinical data, ancillary studies, and molecular analysis","volume":"125","author":"Cho M","year":"2017","journal-title":"Cancer"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2016.2310"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0039\u20106060(97)90215\u20104"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002\u20109610(97)00190\u20106"},{"key":"e_1_2_7_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12565\u2010012\u20100142\u20101"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/0194599811400366"},{"key":"e_1_2_7_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2012.08.026"},{"key":"e_1_2_7_20_2","first-page":"466","article-title":"Fine needle aspiration cytology of parathyroid lesions Korean","volume":"47","author":"Heo I","year":"2013","journal-title":"J Pathol"},{"key":"e_1_2_7_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23863"},{"key":"e_1_2_7_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.21453"},{"key":"e_1_2_7_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/dc.21020"},{"key":"e_1_2_7_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/dc.23528"},{"key":"e_1_2_7_25_2","first-page":"25","article-title":"Aspiration biopsy of tumors of the neck: II. 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They own intellectual property related to Thyroseq. They receive compensation from UPMC in connection with ThyroSeq analyses. All other authors have nothing to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}