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>


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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

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:

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. Taxy, J.; Husain, A; Montag, A. (2009). Biopsy Interpretation: The Frozen Section (1st ed.). Lippincott Williams & Wilkins. pp. 191. ISBN 978-0781767798.