Difference between revisions of "Parathyroid hyperplasia"

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| Caption    = Parathyroid hyperplasia. [[H&E stain]].
| Caption    = Parathyroid hyperplasia. [[H&E stain]].
| Synonyms  =
| Synonyms  =
| Micro      =
| Micro      = classically have abundant adipose tissue, +/-"water-clear" cells with abundant granular/foamy cytoplasm & mild nuclear pleomorphism
| Subtypes  =
| Subtypes  =
| LMDDx      = [[parathyroid adenoma]], [[parathyroid carcinoma]]
| LMDDx      = [[parathyroid adenoma]], [[parathyroid carcinoma]]

Revision as of 01:52, 26 February 2016

Parathyroid hyperplasia
Diagnosis in short

Parathyroid hyperplasia. H&E stain.

LM classically have abundant adipose tissue, +/-"water-clear" cells with abundant granular/foamy cytoplasm & mild nuclear pleomorphism
LM DDx parathyroid adenoma, parathyroid carcinoma
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

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:[4]

Note:

DDx:

Images

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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

  1. 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.
  2. URL: http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970475-2. Accessed on: 29 July 2010.
  3. 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.
  4. 4.0 4.1 Grenko, RT.; Anderson, KM.; Kauffman, G.; Abt, AB. (Nov 1995). "Water-clear cell adenoma of the parathyroid. A case report with immunohistochemistry and electron microscopy.". Arch Pathol Lab Med 119 (11): 1072-4. PMID 7487410.
  5. Taxy, J.; Husain, A; Montag, A. (2009). Biopsy Interpretation: The Frozen Section (1st ed.). Lippincott Williams & Wilkins. pp. 191. ISBN 978-0781767798.