Parathyroid adenomas in the aortopulmonary window

John L. Doppman, Monica C. Skarulis, Clara C. Chen, Richard Chang, Harvey I. Pass, Douglas L. Fraker, H. Richard Alexander, Bruno Niederle, Stephen J. Marx, Jeffrey A. Norton, Samuel A. Wells, Allen M. Spiegel

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

PURPOSE: To describe localization studies in nine patients with ectopic parathyroid adenomas in the aorto-pulmonary window. MATERIALS AND METHODS: Nine patients with ectopic parathyroid tissue (eight adenomas, one hyperplastic gland) in the aortopulmonary window were examined with ultrasound (US), computed tomography (CT), magnetic resonance (MR) imaging, and scintigraphy. Diagnostic arteriography (n = 4) and venous sampling (n = 3) were performed in the first four patients; arteriography for the purpose of staining was attempted in the last five patients. RESULTS: The results of CT and MR imaging studies were positive in eight of nine patients (89%) and five of eight patients (63%), respectively. The results of thallium/technetium scintigraphy were negative in three patients scanned (0%), but the results of a repeat study in one patient were positive (33%). Sestamibi scans were positive in six of six patients (100%). Single photon emission CT was performed in all six patients and enabled distinction between adenomas in the aortopulmonary window and those in the thymus. CONCLUSION: Ectopic parathyroid glands in the aortopulmonary window are usually detected at sestamibi scintigraphy, and SPECT is helpful in distinguishing these adenomas from more common adenomas in the anterior mediastinum. CT and MR imaging studies can also enable this distinction, but imaging must extend below the aortic arch.

Original languageEnglish (US)
Pages (from-to)456-462
Number of pages7
JournalRadiology
Volume201
Issue number2
StatePublished - Nov 1996
Externally publishedYes

Fingerprint

Parathyroid Neoplasms
Adenoma
Radionuclide Imaging
Tomography
Magnetic Resonance Imaging
Single-Photon Emission-Computed Tomography
Angiography
Choristoma
Parathyroid Glands
Thallium
Technetium
Mediastinum
Thoracic Aorta
Thymus Gland
Staining and Labeling
Lung

Keywords

  • Mediastinum, neoplasms
  • Parathyroid, CT
  • Parathyroid, hyperparathyroidism
  • Parathyroid, MR
  • Parathyroid, neoplasm
  • Parathyroid, radionuclide studies
  • Parathyroid, vascular studies

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Doppman, J. L., Skarulis, M. C., Chen, C. C., Chang, R., Pass, H. I., Fraker, D. L., ... Spiegel, A. M. (1996). Parathyroid adenomas in the aortopulmonary window. Radiology, 201(2), 456-462.

Parathyroid adenomas in the aortopulmonary window. / Doppman, John L.; Skarulis, Monica C.; Chen, Clara C.; Chang, Richard; Pass, Harvey I.; Fraker, Douglas L.; Alexander, H. Richard; Niederle, Bruno; Marx, Stephen J.; Norton, Jeffrey A.; Wells, Samuel A.; Spiegel, Allen M.

In: Radiology, Vol. 201, No. 2, 11.1996, p. 456-462.

Research output: Contribution to journalArticle

Doppman, JL, Skarulis, MC, Chen, CC, Chang, R, Pass, HI, Fraker, DL, Alexander, HR, Niederle, B, Marx, SJ, Norton, JA, Wells, SA & Spiegel, AM 1996, 'Parathyroid adenomas in the aortopulmonary window', Radiology, vol. 201, no. 2, pp. 456-462.
Doppman JL, Skarulis MC, Chen CC, Chang R, Pass HI, Fraker DL et al. Parathyroid adenomas in the aortopulmonary window. Radiology. 1996 Nov;201(2):456-462.
Doppman, John L. ; Skarulis, Monica C. ; Chen, Clara C. ; Chang, Richard ; Pass, Harvey I. ; Fraker, Douglas L. ; Alexander, H. Richard ; Niederle, Bruno ; Marx, Stephen J. ; Norton, Jeffrey A. ; Wells, Samuel A. ; Spiegel, Allen M. / Parathyroid adenomas in the aortopulmonary window. In: Radiology. 1996 ; Vol. 201, No. 2. pp. 456-462.
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abstract = "PURPOSE: To describe localization studies in nine patients with ectopic parathyroid adenomas in the aorto-pulmonary window. MATERIALS AND METHODS: Nine patients with ectopic parathyroid tissue (eight adenomas, one hyperplastic gland) in the aortopulmonary window were examined with ultrasound (US), computed tomography (CT), magnetic resonance (MR) imaging, and scintigraphy. Diagnostic arteriography (n = 4) and venous sampling (n = 3) were performed in the first four patients; arteriography for the purpose of staining was attempted in the last five patients. RESULTS: The results of CT and MR imaging studies were positive in eight of nine patients (89{\%}) and five of eight patients (63{\%}), respectively. The results of thallium/technetium scintigraphy were negative in three patients scanned (0{\%}), but the results of a repeat study in one patient were positive (33{\%}). Sestamibi scans were positive in six of six patients (100{\%}). Single photon emission CT was performed in all six patients and enabled distinction between adenomas in the aortopulmonary window and those in the thymus. CONCLUSION: Ectopic parathyroid glands in the aortopulmonary window are usually detected at sestamibi scintigraphy, and SPECT is helpful in distinguishing these adenomas from more common adenomas in the anterior mediastinum. CT and MR imaging studies can also enable this distinction, but imaging must extend below the aortic arch.",
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AU - Doppman, John L.

AU - Skarulis, Monica C.

AU - Chen, Clara C.

AU - Chang, Richard

AU - Pass, Harvey I.

AU - Fraker, Douglas L.

AU - Alexander, H. Richard

AU - Niederle, Bruno

AU - Marx, Stephen J.

AU - Norton, Jeffrey A.

AU - Wells, Samuel A.

AU - Spiegel, Allen M.

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N2 - PURPOSE: To describe localization studies in nine patients with ectopic parathyroid adenomas in the aorto-pulmonary window. MATERIALS AND METHODS: Nine patients with ectopic parathyroid tissue (eight adenomas, one hyperplastic gland) in the aortopulmonary window were examined with ultrasound (US), computed tomography (CT), magnetic resonance (MR) imaging, and scintigraphy. Diagnostic arteriography (n = 4) and venous sampling (n = 3) were performed in the first four patients; arteriography for the purpose of staining was attempted in the last five patients. RESULTS: The results of CT and MR imaging studies were positive in eight of nine patients (89%) and five of eight patients (63%), respectively. The results of thallium/technetium scintigraphy were negative in three patients scanned (0%), but the results of a repeat study in one patient were positive (33%). Sestamibi scans were positive in six of six patients (100%). Single photon emission CT was performed in all six patients and enabled distinction between adenomas in the aortopulmonary window and those in the thymus. CONCLUSION: Ectopic parathyroid glands in the aortopulmonary window are usually detected at sestamibi scintigraphy, and SPECT is helpful in distinguishing these adenomas from more common adenomas in the anterior mediastinum. CT and MR imaging studies can also enable this distinction, but imaging must extend below the aortic arch.

AB - PURPOSE: To describe localization studies in nine patients with ectopic parathyroid adenomas in the aorto-pulmonary window. MATERIALS AND METHODS: Nine patients with ectopic parathyroid tissue (eight adenomas, one hyperplastic gland) in the aortopulmonary window were examined with ultrasound (US), computed tomography (CT), magnetic resonance (MR) imaging, and scintigraphy. Diagnostic arteriography (n = 4) and venous sampling (n = 3) were performed in the first four patients; arteriography for the purpose of staining was attempted in the last five patients. RESULTS: The results of CT and MR imaging studies were positive in eight of nine patients (89%) and five of eight patients (63%), respectively. The results of thallium/technetium scintigraphy were negative in three patients scanned (0%), but the results of a repeat study in one patient were positive (33%). Sestamibi scans were positive in six of six patients (100%). Single photon emission CT was performed in all six patients and enabled distinction between adenomas in the aortopulmonary window and those in the thymus. CONCLUSION: Ectopic parathyroid glands in the aortopulmonary window are usually detected at sestamibi scintigraphy, and SPECT is helpful in distinguishing these adenomas from more common adenomas in the anterior mediastinum. CT and MR imaging studies can also enable this distinction, but imaging must extend below the aortic arch.

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