ETA2022 Poster Presentations Case Reports (9 abstracts)
Differentiation of parathyroid gland from a lymph node in clinical practice
Lilit Kambulyan 1 , Armine Khroyan 2 , Elena Aghajanova 3 , Artashes Tadevosyan 4 & Shushanik Kostandyan 5
1Yerevan State Medical University, Yerevan State Medical University, Endocrinology, Yerevan, Armenia; 2Yerevan State Medical University, Koryun 2, Endocrinology, Yerevan, Armenia; 3Yerevan State Medical University, Muratsan University Hospital, Endocrinology, Yerevan, Armenia; 4Yerevan State Medical University, Yerevan State Medical University, Armenia; 5Yerevan State Medical University, Muratsan University Hospital, Yerevan, Armenia
Introduction: How to differentiate lymphadenitis from parathyroid gland?
Case report: The patient, a 45-year-old woman, applied to “Muratsan” Polyclinic complaining of asthenia, dry skin, easy fatigability, muscle and bone pain, palpitations. Anamnesis was gained and an examination was carried out. According to the patient’s indication in the anamnesis, total thyroidectomy was done a year before, followed by radioiodine therapy with regard to papillary carcinoma of the thyroid gland. A normal menstrual period.
The following examinations have been carried out*
| Test | Result | The result after 3 months | Normal range |
| TSH | 5.42 uIU/mL | 0.43 uIU/mL | 0.27-4.2 uIU/mL |
| FT4 | 1.28 ng/dL | 1.68 ng/dL | 0.93-1.7 ng/dL |
| Vitamin D | 23.43 ng/mL | 34.3 ng/mL | 30-70 ng/mL |
| PTH | 96.06 pg/ml | 103 pg/ml | 15-65 pg/ml |
| Ca | 1.26 mmol/l | 1.21 mmol/l | 1.2-1.32 mmol/l |
| P | 1.3 mmol/l | 1.21 mmol/l | 0.84-1.45 mmol/l |
| Neck ultrasound | A well-defined, homogeneous isoechoic lesion with 35x20 mm in measures (a parathyroid adenoma or lymph nodes?) was detected in the projection of the parathyroid gland from the right side. | ||
| Densitometry | Osteoporosis: T score – 2.7 | ||
| *The examinations have been carried out on the background of 100 mg of levothyroxine. Levothyroxine 150 mg 1x1. vitamin D 5000IU for 3 months, CaD3 1000 mg 1x1 for 3 months were prescribed followed by the same results of the laboratory tests. Due to the high PTH level, the secondary hyperparathyroidism was denied and the patient was directed to scintigraphy. Adenoma of the parathyroid gland was confirmed and surgical treatment was advised. | |||
Conclusion: As the appearance of the parathyroid gland and the lymph node is similar in the sonography, it is advised to check PTH, vitamin D, Ca2+, deny the secondary hyperparathyroidism, then to direct either to scintigraphy or to FNA.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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