Parathyroid gland
Hyperparathyroidism
Primary chief cell hyperplasia


Topic Completed: 1 January 2013

Revised: 6 February 2019

Copyright: 2003-2019, PathologyOutlines.com, Inc.

PubMed Search: Primary chief cell hyperplasia

Monika Roychowdhury, M.D.
Page views in 2018: 516
Page views in 2019 to date: 553
Cite this page: Roychowdhury M. Primary chief cell hyperplasia. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/parathyroidprimarychief.html. Accessed September 24th, 2019.
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
Treatment
  • 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)
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