Difference between revisions of "Parathyroid hyperplasia"
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Parathyroid hyperplasia -- intermed mag.jpg | |||
| Width = | |||
| Caption = Parathyroid hyperplasia. [[H&E stain]]. | |||
| Synonyms = | |||
| Micro = | |||
| Subtypes = | |||
| LMDDx = [[parathyroid adenoma]] | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = all parathyroid glands are enlarged | |||
| Grossing = | |||
| Staging = | |||
| Site = [[parathyroid gland]] | |||
| Assdx = [[chronic renal failure]] | |||
| Syndromes = [[MEN 1]], [[MEN 2A]] | |||
| Clinicalhx = | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = uncommon | |||
| Bloodwork = elevated PTH, +/-elevated calcium | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = | |||
| Other = | |||
| ClinDDx = parathyroid adenoma | |||
| Tx = surgical removal of all parathyroid glands & re-implantation of half of one parathyroid in the forearm | |||
}} | |||
'''Parathyroid hyperplasia''' is an abnormal proliferation of the [[parathyroid gland]]s and a relatively common cause of [[hyperparathyroidism]] that is typically associated with [[chronic renal failure]].<ref name=pmid23267748>{{Cite journal | last1 = Jamal | first1 = SA. | last2 = Miller | first2 = PD. | title = Secondary and tertiary hyperparathyroidism. | journal = J Clin Densitom | volume = 16 | issue = 1 | pages = 64-8 | month = | year = | doi = 10.1016/j.jocd.2012.11.012 | PMID = 23267748 }}</ref> | '''Parathyroid hyperplasia''' is an abnormal proliferation of the [[parathyroid gland]]s and a relatively common cause of [[hyperparathyroidism]] that is typically associated with [[chronic renal failure]].<ref name=pmid23267748>{{Cite journal | last1 = Jamal | first1 = SA. | last2 = Miller | first2 = PD. | title = Secondary and tertiary hyperparathyroidism. | journal = J Clin Densitom | volume = 16 | issue = 1 | pages = 64-8 | month = | year = | doi = 10.1016/j.jocd.2012.11.012 | PMID = 23267748 }}</ref> | ||
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*[[Parathyroid adenoma]] - classically have a rim of normal parathyroid gland around it. | *[[Parathyroid adenoma]] - classically have a rim of normal parathyroid gland around it. | ||
*[[Parathyroid carcinoma]] - has invasive tissue destruction or far away metastases. | *[[Parathyroid carcinoma]] - has invasive tissue destruction or far away metastases. | ||
===Images=== | |||
<gallery> | |||
Image: Parathyroid hyperplasia -- very low mag.jpg | PA - very low mag. (WC) | |||
Image: Parathyroid hyperplasia -- low mag.jpg | PA - low mag. (WC) | |||
Image: Parathyroid hyperplasia -- intermed mag.jpg | PA - intermed. mag. (WC) | |||
Image: Parathyroid hyperplasia -- high mag.jpg | PA - high mag. (WC) | |||
</gallery> | |||
==Sign out== | ==Sign out== | ||
Revision as of 01:44, 26 February 2016
| Parathyroid hyperplasia | |
|---|---|
| Diagnosis in short | |
 Parathyroid hyperplasia. H&E stain. | |
| LM DDx | parathyroid adenoma |
| Gross | all parathyroid glands are enlarged |
| Site | parathyroid gland |
|
| |
| Associated Dx | chronic renal failure |
| Syndromes | MEN 1, MEN 2A |
|
| |
| Prevalence | uncommon |
| Blood work | elevated PTH, +/-elevated calcium |
| Clin. DDx | parathyroid adenoma |
| Treatment | surgical removal of all parathyroid glands & re-implantation of half of one parathyroid in the forearm |
Parathyroid hyperplasia is an abnormal proliferation of the parathyroid glands and a relatively common cause of hyperparathyroidism that is typically associated with chronic renal failure.[1]
General
- Common cause of hyperparathyroidism.
- Usually associated with chronic renal failure.
- May be syndromic - chief cell hyperplasia - associated with MEN 1, MEN 2A.[2]
Gross
- Classically all parathyroid glands are involved; however, some may be spared making it difficult to differentiate this from parathyroid adenoma.[3]
Microscopic
Features:[3]
- Classically have abundant adipose tissue.
- +/-Water-clear cells ("water-clear cell hyperplasia").
Note:
- Generally, it is impossible to discern between parathyroid adenomas and parathyroid hyperplasias by histology alone.[4]
- One requires information of the size of the other glands to make the diagnosis.
DDx:
- Parathyroid adenoma - classically have a rim of normal parathyroid gland around it.
- Parathyroid carcinoma - has invasive tissue destruction or far away metastases.
Images
PA - very low mag. (WC)
PA - low mag. (WC)
PA - intermed. mag. (WC)
PA - high mag. (WC)
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Clinical history is suggestive
A. Right Superior Parathyroid, Excision: - Parathyroid tissue compatible with hyperplasia. B. Right Inferior Parathyroid, Excision: - Parathyroid tissue compatible with hyperplasia. C. Portion of Left Inferior Parathyroid, Excision: - Parathyroid tissue compatible with hyperplasia. D. Left Superior Parathyroid, Excision: - Parathyroid tissue compatible with hyperplasia.
See also
References
- ↑ Jamal, SA.; Miller, PD.. "Secondary and tertiary hyperparathyroidism.". J Clin Densitom 16 (1): 64-8. doi:10.1016/j.jocd.2012.11.012. PMID 23267748.
- ↑ URL: http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970475-2. Accessed on: 29 July 2010.
- ↑ 3.0 3.1 Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson; Aster, Jon (2009). Robbins and Cotran pathologic basis of disease (8th ed.). Elsevier Saunders. pp. 1128. ISBN 978-1416031215.
- ↑ Taxy, J.; Husain, A; Montag, A. (2009). Biopsy Interpretation: The Frozen Section (1st ed.). Lippincott Williams & Wilkins. pp. 191. ISBN 978-0781767798.