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AGNOR Counts in Differential Diagnosis of Parathyroid Adenoma and Hyperplasia in Preoperative Cytologic Smears

Aim: To assess the possibility of differentiating adenoma from hyperplasia in preoperative material by use of AgNOR counts per nucleus in patients with hyperparathyroidism. Methods: Samples obtained by US guided fine-needle aspiration cytology of 67 parathyroid glands without known histopathologic diagnosis were dried and stained by May-Gru¨ nwald-Giemsa and cytochemistry method of selective silver staining of nucleolar organizer regions (AgNOR). Fifty nuclei per sample were analyzed. Mann–Whitney U-test was employed to determine differences in the measured parameters between the groups of patients with parathyroid adenoma and parathyroid hyperplasia. Correlations of parameters were determined by Spearman’s correlation coefficient Rho (r). Results: The mean number of all AgNORs per nucleus was greater in parathyroid hyperplasia than in adenoma, however, this difference did not reach statistical significance. AgNOR count did not correlate with nuclear parameters in either group (parathyroid hyperplasia and parathyroid adenoma). When applied to cell morphology in cytologic smear, it means that the size and form of nucleus do not influence the number of AgNOR per nucleus and vice versa in either group. Conclusion: Therefore, quantitative determination of AgNOR count per nucleus cannot help in differentiating parathyroid adenoma and hyperplasia in preoperative cytologic

AGNOR ; parathyroid adenoma and hyperplasia ; preoperative cytologic smear

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