Abstract
Unregulated overproduction of parathyroid hormone (PTH) from an abnormal parathyroid gland is the origin of primary hyperparathyroidism (PHPT). Patients who have an elevated serum calcium concentration have a problem in one or more of their parathyroid glands. To understand this disease state adequately and provide appropriate treatment, a thorough understanding of parathyroid embryology, anatomy, physiology, and pathophysiology is essential. In this manuscript, we review our current understanding of parathyroid gland embryology, anatomy, histology, physiology, and pathophysiology.
Highlights
Unregulated overproduction of parathyroid hormone (PTH) from an abnormal parathyroid gland is the origin of primary hyperparathyroidism (PHPT)
We review our current understanding of parathyroid gland embryology, anatomy, histology, physiology, and pathophysiology
The normal anatomic location of the superior parathyroid glands is more constant than the inferior parathyroid glands, with 80% of the superior glands being found near the posterior aspect of the thyroid gland at the junction of the upper and middle portion of the thyroid lobes, at the level of the cricoid cartilage [6]
Summary
During the fifth to sixth week of intrauterine development, the embryonic pharynx is marked externally by four branchial clefts of ectoderm origin and internally by five branchial pouches of endoderm origin [1]. The branchial apparatus is made up by the branchial clefts and branchial pouches, together with the branchial arches of mesoderm origin, found in between them [2] This apparatus undergoes normal involution leaving behind some derivatives which include the thyroid gland, parathyroid glands, thymus, ultimobranchial body, Eustachian tube, middle ear, and external auditory canal [3]. The parathyroid glands develop as epithelial thickenings of the dorsal endoderm of the third and fourth branchial pouches [2]. The superior parathyroid glands are derived from the fourth branchial pouch, which gives rise to the thyroid gland [4]. The third branchial pouch gives rise to the inferior parathyroid glands and the thymus [2] [5]. The frequency of intrathyroidal glands is approximately 2% [4] [6] [10]
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