Parathyroid gland - Water clear cell adenoma

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Parathyroid gland

Neoplasms

Water clear cell adenoma

Reviewer: Monika Roychowdhury, M.D. (see Reviewers page)
Revised: 17 February 2013, last major update January 2013
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● Rare; solitary lesion that compresses normal gland (Arch Pathol Lab Med 1995;119:1072)
● Only a few cases reported (Indian J Pathol Microbiol 2004;47:39)

Case reports
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● 56 year old woman with a 2 cm thyroid nodule and elevated serum calcium (Arch Pathol Lab Med 2001;125:256)
● 64 year old HIV+ patient (Diagn Cytopathol. 2011 Dec 5 [Epub ahead of print])
● Case of intrathyroidal tumor (Hum Pathol 2001;32:889)

Micro description
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● Nests and glands composed of cells with abundant foamy, granular cytoplasm, mild nuclear pleomorphism

Micro images
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Various images

Cytology description
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● Cellular smear with single and loosely clustered tumor cells with finely granular and vacuolated light-purple cytoplasm and central nuclei; occasional microfollicular structures may be present; no colloid seen (Diagn Cytopathol 2011 Dec 5 [Epub ahead of print])

Positive stains
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● PTH

Electron microscopy description
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● Glassy and flocculate material

Differential diagnosis
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● Water clear cell hyperplasia of parathyroid gland: diffuse, affects all glands
● Parathyroid chief cell adenoma: may have clear cell change, but some normal chief cells present
● Clear cell changes in a thyroid tumor: typical thyroid tumor cells present
● Metastatic renal cell carcinoma: multiple nodules, optically clear cytoplasm, delicate vasculature, intracytoplasmic glycogen and fat

End of Parathyroid gland > Neoplasms > Water clear cell adenoma

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