Morphological criteria for diagnosis of primary hyperparathyroidism

Abstract

The work performed on the operating material. A morphological study of the parathyroid glands removed in 128 patients with hyperparathyroidism was performed. For the histological study pieces of the parathyroid gland were taken. The pieces were fixed in 10 % buffered formalin for 10 days, then washed in running water, passed through a processor and embedded in paraffin. From paraffin blocks, sections of 5–6 µm were prepared. Sections were stained with hematoxylin and eosin, pikrofuksin according to Van Gieson, toluidine blue, according to Mallory, used CHIC-reaction. The results of the study showed that primary hypothyroidism is more common in women (82 %) aged 41–50 years (42.2 %). The size of the parathyroid glands ranged from 0.3 to 8.2 cm. Adenomas were found in 51.6 % of patients, hyperplasia in 43.0 %, cancer in 5.4 % of them. In primary hyperplasia, there is an increase in all parathyroid glands, upper pair or lower pair. Upper pairs are increased more. Histological examination indicates lobular structure of the gland, lobular hyperplasia, diffuse proliferation of the main, acidophilic and transitional forms of parathyrocytes, monomorphic structure, reduction or absence of stromal fat, the presence of a large number of vessels. Hyperplasia of the main cells was detected in 67 % of patients, hyperplasia of acidophilic cells in 28 %, hyperplasia of light cells in 3 %, mixed hyperplasia in 2 % of them.