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| ==Parathyroid adenoma== | | ==Parathyroid adenoma== |
| ===General===
| | {{Main|Parathyroid adenoma}} |
| *One parathyroid is big... the others are small.
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| *Associated with [[MEN 1]] and [[MEN 2A]].
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| MEN 1:
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| *Parathyroid adenoma.
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| *[[Pancreatic neuroendocrine tumour]].
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| *[[Pituitary adenoma]].
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| MEN 2A:
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| *Parathyroid adenoma.
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| *[[Medullary thyroid carcinoma]].
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| *[[Pheochromocytoma]].
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| ====Subtypes====
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| 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>
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| #Chief cell parathyroid adenoma.
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| #*Common.
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| #Oxyphil parathyroid adenoma.
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| #*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>
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| #Mixed.
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| ===Microscopic===
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| Features - general:
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| *Classically have a rim of normal parathyroid gland around it.<ref name=Ref_BITFS191>{{Ref BITFS|191}}</ref>
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| Note:
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| *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>
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| **One requires information of the size of the other glands to make the diagnosis.
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| ====Chief cell parathyroid adenoma====
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| Features:<ref name=Ref_PBoD8_1127>{{Ref PBoD8|1127}}</ref>
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| *Chief cells - '''key feature''':
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| **Small central nucleus.
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| ***Round with stippled chromatin - '''important'''.
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| **Moderate cytoplasm.
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| *+/-Scattered oxyphil cells:
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| **Large cells.
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| **Abundant cytoplasm.
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| *Architecture:
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| **Nests.
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| **Circular formations - often around capillaries (perivascular pseudo[[rosette]]s).
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| =====Images=====
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| <gallery>
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| Image:Parathyroid_adenoma_low_mag.jpg |Parathyroid adenoma - low mag. (WC/Nephron)
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| Image:Parathyroid_adenoma_high_mag.jpg |Parathyroid adenoma - high mag. (WC/Nephron)
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| </gallery>
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| ====Oxyphil parathyroid adenoma====
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| Features:<ref name=Ref_PBoD8_1127>{{Ref PBoD8|1127}}</ref>
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| *Oxyphil cells:
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| **Large cells.
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| **Abundant cytoplasm.
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| DDx:
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| *[[Hürthle cell adenoma]] of the [[thyroid gland]].
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| Image:
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| *[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>
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| ===Sign out===
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| Note:
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| *One should not say "negative for malignancy".
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| <pre>
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| Parathyroid Gland, Excision:
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| - Chief cell parathyroid adenoma.
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| </pre>
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| <pre>
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| Parathyroid Gland, Excision:
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| - Chief cell parathyroid adenoma with adjacent normal parathyroid tissue.
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| </pre>
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| <pre>
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| Parathyroid Gland (Submitted as "Right Superior Parathyroid Adenoma"), Excision:
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| - Parathyroid adenoma with adjacent normal parathyroid tissue.
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| </pre>
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| ====Block letters====
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| <pre>
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| PARATHRYOID GLAND, EXCISION:
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| - CHIEF CELL PARATHYROID ADENOMA.
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| </pre>
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| ===Micro===
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| 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.
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| ==Parathyroid carcinoma== | | ==Parathyroid carcinoma== |