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CT scan results: hyperparathyroidism??
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Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

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CT scan results: hyperparathyroidism??

Greetings! For hx, see other post “hyperparathyroidism”
Sestamibi scan negative
had a ct scan done looking for parathyroid adenoma, and they found a 3cm mass behind my clavicle (would you expect that to not show up on a sestamibi?)
"just below the the left lobe of the thyroid gland extending to the level of the thoracic inlet"

I am wondering what it means that "the mass shows a relatively low attenuation when compared to the thyroid gland, but Hounsfield units  measurements are of that of soft tissue and not cystic"
and "there is significant beam-hardening artifact extending through the lesion, and the housnfield units are measured at the very superior portion of the lesion at 45 units."  

"the mass is well defined and there is fat surrounding the lesion.  The lesion is continuous with the lower pole of the thyroid gland but is clearly separate from it.

I don't understand the attenuation, housnfield units, or beam hardening artifact and what that means about interpretation of the results.  likely an adenoma?  Likely a lymph node?
It is much larger that I would have expected based on my blood levels.

And are PT adenomas usually of the same composition?  As in, dense, hard, look the same on scans?  Or do they vary a lot?

I will still be following up with the Dr.  But I would like to know what someone else thinks.

Thank you
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97953_tn?1193367871
This sounds like a parathyroid adenoma.  We do not use CT scan here for parathyroid evaluation.  My experience with sestamibi scan name is quite disappointing, with approximately a 50-50 chance of detecting or localizing the tumor.  I would recommend discussing this with your doctor.  In either case a 3 cm neck mass like this does need further evaluation.  This should be easily seen on ultrasound, which in my mind is the preferred pre-operative localization study in patients with parathyroid disease.
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