Parathyroid gland
Primary chief cell hyperplasia

Author: Monika Roychowdhury, M.D. (see Authors page)

Revised: 11 April 2018, last major update January 2013

Copyright: (c) 2003-2018,, Inc.

PubMed Search: Primary chief cell hyperplasia

Cite this page: Roychowdhury, M. Primary chief cell hyperplasia. website. Accessed October 15th, 2018.
Definition / general
  • Parathyromatosis: microscopic foci of hyperplastic parathyroid tissue in neck associated with chief cell hyperplasia and prior surgery (Hum Pathol 1990;21:234)
Case reports
  • Excise 3 of 4 glands
  • Some surgeons remove all parathyroid tissue
  • Can use frozen section, touch prep or intraoperative PTH assay to confirm removal
Gross description
  • Classically, all glands enlarged (up to 10 g) vs. pseudoadenomatous (one gland enlarged) vs. occult (all glands normal size but histologically hyperplastic)
Microscopic (histologic) description
  • Sheets of chief cells, minimal fat, rare oxyphils
  • Usually no rim of normal tissue
Molecular / cytogenetics description
  • Increased production of PTH; associated with MEN 1, 2A / 2 in 30% of cases (not MEN 2B / 3)
  • 50% have allelic loss on #11 (where MEN1 gene is located)