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Review
. 2019 Dec;12(4):1007-1019.
doi: 10.1016/j.path.2019.08.006. Epub 2019 Sep 27.

Parathyroid Pathology

Julie Guilmette  1 , Peter M Sadow  2
Affiliations
Review

Parathyroid Pathology

Julie Guilmette et al. Surg Pathol Clin. 2019 Dec.

Abstract

Proliferative pathologic lesions of parathyroid glands encompass a spectrum of entities ranging from benign hyperplastic processes to malignant neoplasia. This review article outlines the pathophysiologic classification of parathyroid disorders and describes histologic, immunohistochemical, and molecular features that can be assessed to render accurate diagnoses.

Keywords: Parafibromin; Parathyroid; Parathyroid adenoma; Parathyroid carcinoma; Primary hyperplasia.

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Conflict of interest statement

Conflict of interest: There are no conflicts of interest to report by any of the authors.

Figures

Fig. 1.
Fig. 1.
Normal parathyroid gland composed mainly of chief cells and adipocytes with thin fibrous septa dividing gland into lobules (hematoxylineosin [H&E], original magnification ×400).
Fig. 2.
Fig. 2.
(A) Incidental finding of ectopic intrathyroidal parathyroid tissue (H&E, original magnification ×400). (B) Parathyroid hormone (PTH) by immunohistochemistry highlights parathyroid chief cells, allowing proper identification (PTH, original magnification ×400).
Fig. 3.
Fig. 3.
(A) Parathyroid hyperplasia is characterized by chief cell proliferation involving all 4 glands (H&E, original magnification ×200). (B) Nodules of oncocytic cells are common (H&E, original magnification ×400).
Fig. 4.
Fig. 4.
(A) Oncocytic PA with residual normocellular parathyroid tissue identified outside the adenoma capsule (H&E, original magnification ×200). (B) Microcystic or cystic architecture may be observed inside the adenoma (H&E, original magnification ×400).
Fig. 5.
Fig. 5.
Lipoadenoma is a rare variant of PA composed of mature adipose tissue and chief cells (H&E, original magnification ×200).
Fig. 6.
Fig. 6.
(A) Thick fibrotic capsule with parathyroid cells infiltrating surrounding soft tissue associated with (B) true vascular invasion are key features of PC (H&E, original magnification ×200). (C) Microcystic growth pattern in PC with unremarkable bland cytologic features (H&E, original magnification ×400).
See this image and copyright information in PMC

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