David A.Kumpe(parathyroid embChina100912)课件.pptVIP

* * * * * * * * * * * * * * 19-year-old female Hx large kidney stone, Hypercalcemia Dx 1o hyperparathyroidism Sestamibi scan ? ? Lt mediastinal adenoma 2nd Venous sampling – positive 07/7/2011 Sestamibi scan 07/28/2011 – Chest CT PTH 314 - 537 PTH 11,017 Repeat venous sampling Huge stepup in Lt mediastinal vein indicates Lt mediastinal adenoma Lt thyrocervical trunk – no adenoma Bronchial supply to adenoma Bronchial connection to Lt inferior thyroid Small descending branch from Lt inferior thyroid Bronchial Aorta Bronchial Adenoma Bronchial Rt bronchial a. Lt bronchial a. Bronchia