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.
Biopsy - parathyroid
How the Test is Performed
There are two parathyroid glands on each 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 level 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, including any herbs or supplements. Tell your health care provider if you are taking any blood thinning medications (aspirin, heparin, Lovenox, warfarin), 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.
There is no swelling, hormone levels appear normal, and cells from the tissue sample are normal.
What Abnormal Results Mean
The test confirms that a parathyroid gland is enlarged if hormone levels are too high, or cells from the sample are abnormal. Abnormal PTH levels may also be a cause of 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)
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 develop temporary hoarseness when the nerve that runs close to the parathyroid glands is injured.
You can return to normal activities the same day.
Pellitteri PK, Sofferman RA, Randolph GW. Management of parathyroid disorders. In: Flint PW, Haughey BH, Lund VJ, et al, eds. Cummings Otolaryngology Head and Neck Surgery. 5th ed. Philadelphia, PA: Mosby Elsevier; 2010:chap 125.
Reviewed By: John A. Daller, MD, PhD, Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.