RT Journal
A1 Clark OH
T1 CYstic parathyroid lesions—invited critique
JF Archives of Surgery
JO Archives of Surgery
YR 2009
FD January 19
VO 144
IS 1
SP 56
OP 56
DO 10.1001/archsurg.2008.506
UL http://dx.doi.org/10.1001/archsurg.2008.506
AB 
What is the usual presentation of patients with parathyroid cysts? Patients with NPCs usually have a large cystic mass (median, 5.0-cm diameter in this series) as observed by physical examination or ultrasonography or at operation. Fine-needle aspiration usually (65% [13 of 20 patients] in this series) reveals clear colorless fluid. Such fluid is virtually pathognomonic for parathyroid cysts. Parathyroid hormone assay of the cyst fluid can confirm the diagnosis, although it is probably unnecessary when the fluid of a cyst is clear and colorless. When cyst fluid is yellow or turbid, however, assaying for PTH level certainly can establish the correct diagnosis. Most articles in the literature suggest using a midregional or C-terminal assay rather than an N-terminal PTH assay, because midregional assays are more likely to confirm the diagnosis.