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Pathology - Parathyroid hyperplasia
Definition: An augmentation of parathyroid cell mass without an identifiable trigger.
Epidemiology • Rare, constituting around 20% of primary hyperparathyroidism. • Women are impacted more significantly than men, at a ratio of 3:1.
Aetiology • The majority of patients exhibit sporadic hyperplasia without a discernible etiology. • Approximately 20% of cases are attributed to family illness, predominantly Multiple Endocrine Neoplasia (MEN). 1.
Pathogenesis • Parathyroid hyperplasia results in excessive secretion of parathyroid hormone (PTH). Elevated PTH levels induce hypercalcemia via enhancing calcium absorption from the gastrointestinal tract and kidneys, as well as by augmenting osteoclastic activity in bone.
Presentation • individuals exhibit primary hyperparathyroidism, a biochemical illness characterized by hypercalcemia and an abnormally normal or elevated PTH level. • Numerous individuals are asymptomatic when this condition is identified accidentally. • Some individuals may exhibit nonspecific symptoms such as tiredness, nausea, constipation, polyuria, and arthralgia.
Macroscopy • All parathyroid glands exhibit hypertrophy, with weights exceeding 60 mg and dimensions surpassing 6 mm, but with variability among the glands.
Histopathology • The principal characteristic is an augmentation of cellular mass within the gland, correlated with a reduction in adipose content. • Typically, there is an elevation in both primary and oncocytic cell types. Secondary fibrosis and hemorrhage are prevalent observations.
Prognosis: Excellent after subtotal parathyroidectomy.
Definition: An augmentation of parathyroid cell mass without an identifiable trigger.
Epidemiology • Rare, constituting around 20% of primary hyperparathyroidism. • Women are impacted more significantly than men, at a ratio of 3:1.
Aetiology • The majority of patients exhibit sporadic hyperplasia without a discernible etiology. • Approximately 20% of cases are attributed to family illness, predominantly Multiple Endocrine Neoplasia (MEN). 1.
Pathogenesis • Parathyroid hyperplasia results in excessive secretion of parathyroid hormone (PTH). Elevated PTH levels induce hypercalcemia via enhancing calcium absorption from the gastrointestinal tract and kidneys, as well as by augmenting osteoclastic activity in bone.
Presentation • individuals exhibit primary hyperparathyroidism, a biochemical illness characterized by hypercalcemia and an abnormally normal or elevated PTH level. • Numerous individuals are asymptomatic when this condition is identified accidentally. • Some individuals may exhibit nonspecific symptoms such as tiredness, nausea, constipation, polyuria, and arthralgia.
Macroscopy • All parathyroid glands exhibit hypertrophy, with weights exceeding 60 mg and dimensions surpassing 6 mm, but with variability among the glands.
Histopathology • The principal characteristic is an augmentation of cellular mass within the gland, correlated with a reduction in adipose content. • Typically, there is an elevation in both primary and oncocytic cell types. Secondary fibrosis and hemorrhage are prevalent observations.
Prognosis: Excellent after subtotal parathyroidectomy.
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