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Parathyroid biopsy

Definition

A parathyroid biopsy is the removal of a small piece of a parathyroid gland for examination under a microscope. The parathyroid glands are found just behind the thyroid gland on each side of the neck.

See also:

• Hyperparathyroidism
• Parathyroid adenoma
• Parathyroid hyperplasia

Alternative Names

Biopsy - parathyroid

How the test is performed

There are two parathyroid glands on either side of the neck, making a total of four glands. The parathyroid glands cannot be felt with the hands.

A parathyroid biopsy is done while you are awake. Using an ultrasound machine, the health care provider locates the gland that is of concern. A thin needle is inserted directly into the gland, and a small piece of tissue is removed. The procedure takes 10 - 30 minutes.

The tissue is sent to a laboratory, where it is examined under a microscope. The levels of parathyroid hormone (PTH) in your blood will also be checked.

How to prepare for the test

Tell your health care provider if you have any drug allergies or bleeding problems, or if you are pregnant.

Make sure the health care provider knows about all the medications you are taking. Tell your health care provider if you are taking any blood thinning medications (aspirin, heparin, Lovenox), because you may have to stop taking them a few days before the procedure.

You must sign a consent form.

How the test will feel

The test feels like a quick needle jab or stick. You may feel a sting as the needle is inserted into the gland. Most people do not need any pain medication.

Why the test is performed

The parathyroid glands release parathyroid hormone (PTH). This hormone controls the level of calcium in the body.

This procedure is most often done to rule out cancer as a cause of high parathyroid hormone levels.

It may also be done if an ultrasound exam shows a larger-than-normal parathyroid gland.

Normal Values

There is no swelling, hormone levels appear normal, and cells from the tissue sample are normal.

Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

What abnormal results mean

The test confirms that a parathyroid gland is enlarged, if hormone levels are too high, or if cells from the sample are abnormal. Abnormal PTH levels may also be due to hypercalcemia.

Abnormal results may be due to:

• Parathyroid adenoma or carcinoma (rare)
• Parathyroid hyperplasia
• Multiple endocrine neoplasia I (MEN I)
• Multiple endocrine neoplasia II (MEN II)

What the risks are

The main risks of the procedure are bruising and bleeding into or around the thyroid gland. If bleeding is severe, it may put pressure over the windpipe (trachea). This complication is rare.

In rare cases, some people may develop temporary hoarseness when the nerve that runs close to the parathyroid glands is injured.

Special considerations

You can return to normal activities the same day.