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| *Metastasis. | | *Metastasis. |
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| =Parathyroid tissue= | | =Parathyroid glands= |
| General:
| | {{Main|Parathyroid glands}} |
| *Identification of normal can be tricky.
| | *May make an appearance in the context of thyroid surgery. |
| | |
| Features:<ref>[http://www.medicalhistology.us/twiki/pub/Main/ChapterFourteenSlides/b56b_parathyroid_40x_he_labeled.jpg http://www.medicalhistology.us/twiki/pub/Main/ChapterFourteenSlides/b56b_parathyroid_40x_he_labeled.jpg]</ref>
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| *Low power:
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| **May vaguely resemble lymphoid tissue - may have hyperchromatic cytoplasm.
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| ***Does ''not'' have follicular centres like a lymph node.
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| **May form gland-like structure and vaguely resemble the thyroid at low power.
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| **Cytoplasm may be clear<ref>[http://pathology.mc.duke.edu/research/Histo_course/parathyroid2.jpg http://pathology.mc.duke.edu/research/Histo_course/parathyroid2.jpg]</ref> - '''key feature'''.
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| **Surrounded by a thin fibrous capsule.
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| *High power:
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| **Mixed cell population:<ref>[http://www.bu.edu/histology/p/15002loa.htm http://www.bu.edu/histology/p/15002loa.htm]</ref>
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| ***Chief cells - predominant cell type, small, cytoplasm has variable staining (hyperchromatic-clear-eosinophilic).
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| ***Oxyphil cells (''acid staining'' cells<ref>[http://dictionary.reference.com/search?q=oxyphil%20cell http://dictionary.reference.com/search?q=oxyphil%20cell]</ref>) - abundant cytoplasm.
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| ***Adipocytes - increased with age, may be used to help differentiate from thyroid - '''key feature'''.
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| {| class="wikitable"
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| | '''Name''' || '''Staining (cytoplasm)''' || '''Quantity of cells''' || '''Cytoplasm (quantity)''' || '''Function'''
| |
| |-
| |
| | (parathyroid) chief cells || intense hyperchromatic to eosinophilic (see note) || abundant || moderate || manufacture PTH
| |
| |-
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| | oxyphil cells || moderate/light hyperchromatic to eosinophilic || rare || abundant || ?
| |
| |}
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| Notes:
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| *Cytoplasmic staining varies considerably on H&E preparations - it may vary from hyperchromatic<ref>[http://www.deltagen.com/target/histologyatlas/atlas_files/endocrine/parathyroid_and_thyroid_glands_20x.jpg http://www.deltagen.com/target/histologyatlas/atlas_files/endocrine/parathyroid_and_thyroid_glands_20x.jpg]</ref> to clear to eosinophilic<ref>[http://instruction.cvhs.okstate.edu/Histology/HistologyReference/hrendo.htm http://instruction.cvhs.okstate.edu/Histology/HistologyReference/hrendo.htm]</ref>.
| |
| *Chief cells tend to stain more intensely than oxyphil cells.
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| | |
| Thyroid vs. parathyroid (see: [http://instruction.cvhs.okstate.edu/Histology/HistologyReference/imagesco/parathyroid2F.jpg parathyroid image]):
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| *Parathyroid cytoplasm:
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| **Hyperchromatic.
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| | |
| Parathyroid vs. lymphoid tissue (see [http://www.deltagen.com/target/histologyatlas/atlas_files/endocrine/parathyroid_and_thyroid_glands_20x.jpg parathyroid image]):
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| *Parathyroid:
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| **No germinal centres.
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| **Gland-like/follicular-like arrangement -- much smaller than normal follicles of
| |
| **Occasional cell with rim of clear cytoplasm (oxyphil?).
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| Images:
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| *[http://library.med.utah.edu/WebPath/ENDOHTML/ENDO031.html Parathyroid - med.utah.edu].
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| *[http://pathology.mc.duke.edu/research/PTH225.html Histology - several images. - pathology.mc.duke.edu].
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| ==Parathyroid hyperplasia==
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| *Parathyroid hyperplasia - classically assoc. with renal failure.
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| *Chief cell hyperplasia - associated with MEN I, MEN IIa.<ref>URL: [http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970475-2 http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970475-2]. Accessed on: 29 July 2010.</ref>
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| ==Parathryoid adenoma==
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| *One parathyroid is big... the others are small.
| |
| *Associated with [[MEN I]] and [[MEN]] IIa/b (II/III).
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| | |
| MEN I:
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| *Parathyroid adenoma.
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| *Pancreatic neuroendocrine tumours.
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| *[[Pituitary adenoma]].
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| MEN IIa/IIb (II/III):
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| *Parathyroid adenoma.
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| *Medullary thyroid carcinoma.
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| *[[Pheochromocytoma]].
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| Image: [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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| =Benign= | | =Benign= |