Endocrine Abstracts

Aim: The aim of this study is to correlate the histopathological cell types and morphologic features of parathyroid neoplasms with ultrasound(US) images and laboratory findings, and also gain more information about the clinical importance of these results.

Materials and methods: The parathyroid lesions of 57 patients who were operated for hyperparathyroidism were sampled on saggital plane. The slides were scanned on high resolution and digital whole slide images were formed. The system was consisted of motorized microscope, motorized table, robotic slide loader, and a high resolution camera. The slide on the motorized table was automatically scanned with the chosen objective and a high resolution image was formed. This image was opened with the help of an interface and then examined. These images can be archived. The US and the slide images were matched by the manufacturer software program.

Results: Forty three patients were female (73.7%). The ages of the patients were between 21–48 years and the median was 53. The study population had 47 adenomas, 7 atypical adenomas, 2 carcinomas. The median of parathormone (PTH) was 194 pg/ml (min–max: 53–2800), median of the tissue area was 96.29 (min–max: 16.01–576.05). Hypoechogenic areas on ultrasound(US) were matched with chief cells in 21 (55.3%), oncocytic cells in 2(5.0%), cyctic morphology in 8(20.0%) cases. There were less chief cells and more connective tissue in hyperechogenic areas (P<0.05). Hyperechogenic areas had less clear cells than isoechoic areas (P<0.05). Lipoic tissue ratio was significantly less in hypoechoic areas than hyperechoic areas (P<0.05). There was no significant difference between echogenicity, oncocytic cells, and haemorrhagia. There was a significant positive correlation between PTH and total neoplasm area (r=0.377, P=0.004). There was no significant difference between cyctic area ratio and chief cell amount in atypical and other cases(P>0.05). A moderate positive lineer relationship was found between serum calcium levels and cyctic area ratio and percentage (r=0.416, P=0.048).

Conclusion: The morphologies of parathyroid neoplasms taken from the digital whole slide images were compared to US projections in the study. However, hypoechogenic areas of US images were matched with chief cells, hyperechogenic areas were compatible with connective and adipose tissues in histopathology. The positive lineer relationship between serum calcium levels and cyctic areas was open to new researches. Results of this study may guide the evaluation of the clinic outcomes of detailed morphometric studies with digital whole slide method.