Difference between revisions of "Parathyroid glands"

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==Parathyroid adenoma==
==Parathyroid adenoma==
===General===
{{Main|Parathyroid adenoma}}
*One parathyroid is big... the others are small.
*Associated with [[MEN 1]] and [[MEN 2A]].
 
MEN 1:
*Parathyroid adenoma.
*[[Pancreatic neuroendocrine tumour]].
*[[Pituitary adenoma]].
 
MEN 2A:
*Parathyroid adenoma.
*[[Medullary thyroid carcinoma]].
*[[Pheochromocytoma]].
 
====Subtypes====
Histologic subtyping:<ref name=pmid16203274>{{Cite journal  | last1 = Moran | first1 = CA. | last2 = Suster | first2 = S. | title = Primary parathyroid tumors of the mediastinum: a clinicopathologic and immunohistochemical study of 17 cases. | journal = Am J Clin Pathol | volume = 124 | issue = 5 | pages = 749-54 | month = Nov | year = 2005 | doi = 10.1309/WJEL-N05L-9A06-9DU0 | PMID = 16203274 }}</ref>
#Chief cell parathyroid adenoma.
#*Common.
#Oxyphil parathyroid adenoma.
#*Uncommon.<ref name=pmid15579742>{{Cite journal  | last1 = Fleischer | first1 = J. | last2 = Becker | first2 = C. | last3 = Hamele-Bena | first3 = D. | last4 = Breen | first4 = TL. | last5 = Silverberg | first5 = SJ. | title = Oxyphil parathyroid adenoma: a malignant presentation of a benign disease. | journal = J Clin Endocrinol Metab | volume = 89 | issue = 12 | pages = 5948-51 | month = Dec | year = 2004 | doi = 10.1210/jc.2004-1597 | PMID = 15579742 }}</ref>
#Mixed.
 
===Microscopic===
Features - general:
*Classically have a rim of normal parathyroid gland around it.<ref name=Ref_BITFS191>{{Ref BITFS|191}}</ref>
 
Note:
*Generally, it is impossible to discern between [[parathyroid adenoma]]s and [[parathyroid hyperplasia]]s by histology alone.<ref name=Ref_BITFS191>{{Ref BITFS|191}}</ref>
**One requires information of the size of the other glands to make the diagnosis.
 
====Chief cell parathyroid adenoma====
Features:<ref name=Ref_PBoD8_1127>{{Ref PBoD8|1127}}</ref>
*Chief cells - '''key feature''':
**Small central nucleus.
***Round with stippled chromatin - '''important'''.
**Moderate cytoplasm.
*+/-Scattered oxyphil cells:
**Large cells.
**Abundant cytoplasm.
*Architecture:
**Nests.
**Circular formations - often around capillaries (perivascular pseudo[[rosette]]s).
 
=====Images=====
<gallery>
Image:Parathyroid_adenoma_low_mag.jpg |Parathyroid adenoma - low mag. (WC/Nephron)
Image:Parathyroid_adenoma_high_mag.jpg |Parathyroid adenoma - high mag. (WC/Nephron)
</gallery>
 
====Oxyphil parathyroid adenoma====
Features:<ref name=Ref_PBoD8_1127>{{Ref PBoD8|1127}}</ref>
*Oxyphil cells:
**Large cells.
**Abundant cytoplasm.
 
DDx:
*[[Hürthle cell adenoma]] of the [[thyroid gland]].
 
Image:
*[http://library.med.utah.edu/WebPath/jpeg4/ENDO091.jpg Parathyroid adenoma (med.utah.edu)].<ref>URL: [http://library.med.utah.edu/WebPath/EXAM/IMGQUIZ/enfrm.html http://library.med.utah.edu/WebPath/EXAM/IMGQUIZ/enfrm.html]. Accessed on: 6 December 2010.</ref>
 
===Sign out===
Note:
*One should not say "negative for malignancy".
 
<pre>
Parathyroid Gland, Excision:
- Chief cell parathyroid adenoma.
</pre>
 
<pre>
Parathyroid Gland, Excision:
- Chief cell parathyroid adenoma with adjacent normal parathyroid tissue.
</pre>
 
<pre>
Parathyroid Gland (Submitted as "Right Superior Parathyroid Adenoma"), Excision:
- Parathyroid adenoma with adjacent normal parathyroid tissue.
</pre>
 
====Block letters====
<pre>
PARATHRYOID GLAND, EXCISION:
- CHIEF CELL PARATHYROID ADENOMA.
</pre>
 
===Micro===
The section shows an adenoma consisting predominantly of chief cells. A rim of normal parathyroid is seen adjacent to the adenoma. A small amount of unremarkable adipose tissue is present.


==Parathyroid carcinoma==
==Parathyroid carcinoma==
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