Thyroid & parathyroid
Parathyroid nonmalignant
Other nonneoplastic parathyroid
Last author update: 1 January 2013
Last staff update: 17 August 2023
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PubMed Search: Parathyroid cysts[TI]
Table of Contents
Definition / general | Terminology | Clinical features | Radiology images | Case reports | Treatment | Clinical images | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stainsCite this page: Roychowdhury M., Gulwani H. Other nonneoplastic parathyroid. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/parathyroidothernonneoplastic.html. Accessed November 27th, 2024.
Definition / general
- Parathyroid cyst: rare cause of neck swelling, accounting for 0.6% of thyroid and parathyroid lesions (Br J Hosp Med (Lond) 2012;73:108)
Terminology
- Parathyromatosis: microscopic foci of hyperplastic parathyroid tissue in neck associated with chief cell hyperplasia and prior surgery (Hum Pathol 1990;21:234)
Clinical features
Parathyroid cyst
- Pure cysts are present at any age; contain high levels of parathyroid hormone; can diagnose by FNA via PTH in fluid (Am J Clin Pathol 1986;86:776)
- Parathyroid derives from third and fourth branchial pouch, as does thymus
- Cysts may be present in low cervical or anterosuperior mediastinum
- Patients usually are normocalcemic and present with an asymptomatic mass
- May be hyperplastic gland (Am J Clin Pathol 1982;77:104), adenoma with cystic degeneration, heterotopic salivary gland-like tissue (Am J Surg Pathol 2000;24:837)
- Can diagnose by FNA if PTH in fluid (Am J Clin Pathol 1986;86:776)
- Cystic parathyroid lesions often contain turbid or colored fluid
- Functional parathyroid cysts more common than nonfunctional parathyroid cysts (Arch Surg 2009;144:52)
- During resection, cyst rupture should be avoided and patients with large cysts should be managed expectantly to forestall the development of symptomatic hypocalcemia
Radiology images
Contributed by Ayana Suzuki, C.T.
Parathyroid cyst: large multilocular cyst
Case reports
- 40 year old man with amyloid goiter with parathyroid involvement (Arch Pathol Lab Med 2000;124:281)
- 46 year old woman with thyroid nodule (Indian J Pathol Microbiol 1996;39:297)
- 50 year old woman with cystic cervical lesion (Med Ultrason 2011;13:157)
- 57 year old man with renal stones (Am J Clin Pathol 1991;96:348)
- 58 year old woman with rare case of malignant hypercalcemia (Case Report Med 2012;2012:851941)
- 66 year old man with a palpable neck mass and hypercalcemia (West J Med 1999;170:118)
- 2 cases of chronic parathyroiditis associated with parathyroid hyperplasia and hyperparathyroidism (Am J Surg Pathol 1984;8:211)
Treatment
- Parathyroid cyst: simple aspiration to diagnosis and treat, ethanol ablation for recurrent cases (Eur J Radiol 2013;82:316)
Clinical images
Contributed by Ayana Suzuki, C.T.
Parathyroid cyst: clear fluid
Gross description
Parathyroid cyst
- Usually large, in inferior glands
- 1 - 10 cm, unilocular, thin walled, clear fluid containing PTH, no nodules
Microscopic (histologic) description
Parathyroid cyst
- Lined by flattened parathyroid chief cells, oxyphils, clear cells; no nodules
- Cyst wall has uniform thickness
- May contain granular material resembling colloid
- No cholesterol granulomas, no cartilage, no smooth muscle
Microscopic (histologic) images
Images hosted on other servers:
Parathyroid cyst: islands of parathyroid tissue
CMV
parathyroiditis in
immunosuppressed
child
Positive stains
- Parathyroid cyst: Chromogranin A, glycogen, PTH
Negative stains
- Parathyroid cyst: Thyroglobulin
