Nefunkcionalna cista paratiroidne žlezde-dijagnostička zamka
Sažetak
Uvod: Paratiroidne ciste su relativno retke i mogu da izgledaju kao koloidno degenerisani čvorovi u štitastoj žlezdi. Za paratiroidne ciste je karakterističan povišen nivo paratiroidnog hormona (PTH) u cističnoj tečnosti.
Prikaz bolesnika: Prikazali smo slučaj sredovečne žene sa palpabilnim čvorom u levom režnju štitaste žlezde. Ultrazvučnim preglednom je ustanovljena anehogena, ovalna promena 40x25mm. Aspiracijom je dobijeno 13ml bezbojne, bistre tečnosti. PTH u cističnoj tečnosti je bio desetostruko veći u odnosu na vrednost PTH u serumu koji je bio blago povišen, vitamin D snižen, kalcijum, fosfor i tiroidni hormoni su bili u granicama referentnih vrednosti. Tireoglobulinska i TPOantitela nisu detektovana. Scintigrafija paratiroidnih žlezda je pokazala fiziološku distribuciju radiofarmaka. Posle 6 meseci nadoknade D vitamina, nalaz PTH, D vitamina, kalcijuma, fosfora i TSH u serumu je bio u granicama referentnih vrednosti. Ovi nalazi su ukazivali da je opisana promena u levom lobusu odgovarala nefunkcionalnoj cisti paratiroidne žlezde.
Zaključak: Cilj ovog prikaza je bio da ukaže na mogućnost da cistične lezije u projekciji štitaste žlezde, tankih zidova, sa reverberacijom na ultrazvučnom pregledu, mogu da budu paratiroidne ciste. Prilikom aspiracije paratiroidnih cisti može da dođe do hiperkalcemične krize koja može da bude životno ugrožavajuće stanje.
Ključne reči: paratiroidne ciste, hiperkalcemična kriza, FNA
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