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| high | | high | ||
| high | | high | ||
| persistent hyperparathyroidism after renal transplant<ref name=emed_hyperparathyroid_tertiary>URL: [http://emedicine.medscape.com/article/127351-overview#aw2aab6b6 http://emedicine.medscape.com/article/127351-overview#aw2aab6b6]. Accessed on: 24 January 2013.</ref> | | persistent hyperparathyroidism after renal transplant;<ref name=emed_hyperparathyroid_tertiary>URL: [http://emedicine.medscape.com/article/127351-overview#aw2aab6b6 http://emedicine.medscape.com/article/127351-overview#aw2aab6b6]. Accessed on: 24 January 2013.</ref> arises in the context of secondary hyperparathyroidism<ref name=pmid26163537>{{Cite journal | last1 = Duan | first1 = K. | last2 = Gomez Hernandez | first2 = K. | last3 = Mete | first3 = O. | title = Clinicopathological correlates of hyperparathyroidism. | journal = J Clin Pathol | volume = 68 | issue = 10 | pages = 771-87 | month = Oct | year = 2015 | doi = 10.1136/jclinpath-2015-203186 | PMID = 26163537 }}</ref> | ||
|} | |} | ||
====Genetics==== | |||
Genes implicated in hyperparathyroidism:<ref name=pmid22187299>{{Cite journal | last1 = Starker | first1 = LF. | last2 = Akerström | first2 = T. | last3 = Long | first3 = WD. | last4 = Delgado-Verdugo | first4 = A. | last5 = Donovan | first5 = P. | last6 = Udelsman | first6 = R. | last7 = Lifton | first7 = RP. | last8 = Carling | first8 = T. | title = Frequent germ-line mutations of the MEN1, CASR, and HRPT2/CDC73 genes in young patients with clinically non-familial primary hyperparathyroidism. | journal = Horm Cancer | volume = 3 | issue = 1-2 | pages = 44-51 | month = Apr | year = 2012 | doi = 10.1007/s12672-011-0100-8 | PMID = 22187299 }}</ref><ref name=pmid23652676>{{Cite journal | last1 = Hendy | first1 = GN. | last2 = Cole | first2 = DE. | title = Genetic defects associated with familial and sporadic hyperparathyroidism. | journal = Front Horm Res | volume = 41 | issue = | pages = 149-65 | month = | year = 2013 | doi = 10.1159/000345675 | PMID = 23652676 }}</ref> | |||
*MEN1. | |||
*CASR. | |||
*HRPT2/CDC73. | |||
*CDKN1B. | |||
*RET. | |||
====Hypercalcemia DDx==== | ====Hypercalcemia DDx==== | ||
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Note: | Note: | ||
*Hyperparathyroidism and FHH are assoc. with an increased PTH.<ref name=Ref_PBoD8_1129>{{ | *Hyperparathyroidism and FHH are assoc. with an increased PTH.<ref name=Ref_PBoD8_1129>{{Ref PBoD8|1129}}</ref> | ||
**Other causes are assoc. with a decreased PTH. | **Other causes are assoc. with a decreased PTH. | ||
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====Parathyroid cell types==== | ====Parathyroid cell types==== | ||
{| class="wikitable" | {| class="wikitable" | ||
! Name | |||
! Staining (cytoplasm) | |||
! Quantity of cells | |||
! Cytoplasm (quantity) | |||
! Function | |||
! Image | |||
|- | |- | ||
| (parathyroid) chief cells | | (parathyroid) chief cells | ||
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| moderate | | moderate | ||
| manufacture parathyroid <br>hormone (PTH) | | manufacture parathyroid <br>hormone (PTH) | ||
| [[Image:Parathyroid adenoma - chief cells -- high mag.jpg|thumb|center|85px|Chief cells (WC)]] | |||
|- | |- | ||
| oxyphil cells | | oxyphil cells | ||
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| abundant | | abundant | ||
| ? | | ? | ||
| [[Image:Parathyroid adenoma - oxyphil cells -- high mag.jpg|thumb|center|85px|Oxyphil cells (WC)]] | |||
|} | |} | ||
Notes: | Notes: | ||
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**Hyperchromatic. | **Hyperchromatic. | ||
Notes: | |||
*Thyroid often has birefringent (calcium oxalate) crystals (60 of 80 cases) whereas parathyroid less often does (2 or 20 cases).<ref name=pmid24618617>{{cite journal |authors=Wong KS, Lewis JS, Gottipati S, Chernock RD |title=Utility of birefringent crystal identification by polarized light microscopy in distinguishing thyroid from parathyroid tissue on intraoperative frozen sections |journal=Am J Surg Pathol |volume=38 |issue=9 |pages=1212–9 |date=September 2014 |pmid=24618617 |doi=10.1097/PAS.0000000000000204 |url=}}</ref> | |||
*Thyroid usually follicular - though parathyroid occasionally is pseudofollicular. | |||
====Parathyroid versus lymphoid tissue==== | ====Parathyroid versus lymphoid tissue==== | ||
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*[http://www.deltagen.com/target/histologyatlas/atlas_files/endocrine/parathyroid_and_thyroid_glands_20x.jpg Parathyroid image (deltagen.com)]. | *[http://www.deltagen.com/target/histologyatlas/atlas_files/endocrine/parathyroid_and_thyroid_glands_20x.jpg Parathyroid image (deltagen.com)]. | ||
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1770637/figure/f1/ Parathyroid gland (nih.gov)].<ref name=pmid15790694>{{Cite journal | last1 = Johnson | first1 = SJ. | last2 = Sheffield | first2 = EA. | last3 = McNicol | first3 = AM. | title = Best practice no 183. Examination of parathyroid gland specimens. | journal = J Clin Pathol | volume = 58 | issue = 4 | pages = 338-42 | month = Apr | year = 2005 | doi = 10.1136/jcp.2002.002550 | PMID = 15790694 | pmc = 1770637 }}</ref> | *[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1770637/figure/f1/ Parathyroid gland (nih.gov)].<ref name=pmid15790694>{{Cite journal | last1 = Johnson | first1 = SJ. | last2 = Sheffield | first2 = EA. | last3 = McNicol | first3 = AM. | title = Best practice no 183. Examination of parathyroid gland specimens. | journal = J Clin Pathol | volume = 58 | issue = 4 | pages = 338-42 | month = Apr | year = 2005 | doi = 10.1136/jcp.2002.002550 | PMID = 15790694 | pmc = 1770637 }}</ref> | ||
===IHC=== | |||
*GATA3 +ve (>98%<ref name=pmid27097544>{{Cite journal | last1 = Takada | first1 = N. | last2 = Hirokawa | first2 = M. | last3 = Suzuki | first3 = A. | last4 = Higuchi | first4 = M. | last5 = Kuma | first5 = S. | last6 = Miyauchi | first6 = A. | title = Diagnostic value of GATA-3 in cytological identification of parathyroid tissues. | journal = Endocr J | volume = 63 | issue = 7 | pages = 621-6 | month = Jul | year = 2016 | doi = 10.1507/endocrj.EJ15-0700 | PMID = 27097544 }}</ref>). | |||
*PTH -ve/+ve (~33%<ref name=pmid27097544/>). | |||
*Chromogranin A +ve (~80%<ref name=pmid27097544/>). | |||
*AE1/AE3 +ve.{{fact}}<!-- {{Cite journal | last1 = Piciu | first1 = D. | last2 = Irimie | first2 = A. | last3 = Kontogeorgos | first3 = G. | last4 = Piciu | first4 = A. | last5 = Buiga | first5 = R. | title = Highly aggressive pathology of non-functional parathyroid carcinoma. | journal = Orphanet J Rare Dis | volume = 8 | issue = | pages = 115 | month = Aug | year = 2013 | doi = 10.1186/1750-1172-8-115 | PMID = 23915575 }} --> | |||
=Specific entities= | =Specific entities= | ||
==Parathyroid hyperplasia== | ==Parathyroid hyperplasia== | ||
{{Main|Parathyroid hyperplasia}} | |||
==Parathyroid adenoma== | ==Parathyroid adenoma== | ||
{{Main|Parathyroid adenoma}} | |||
==Parathyroid carcinoma== | ==Parathyroid carcinoma== | ||
{{Main|Parathyroid carcinoma}} | |||
=See also= | =See also= |
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