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[Optical and ultrastructural morphology in hyperparathyroidism during dialysis]
E Schiaffino1, C Zogno, C Schmid
1Servizio di Anatomia Patologica, Ospedale San Carlo Borromeo di Milano.
Pathologica
|July 1, 1992
Summary
Chronic kidney disease patients undergoing dialysis often develop parathyroid gland hyperplasia. Morphological analysis revealed no differences between hyperplastic and adenomatous glands, but some showed aneuploid DNA content.
Area of Science:
- Nephrology
- Endocrinology
- Surgical Pathology
Background:
- Secondary hyperparathyroidism is a common complication in patients with chronic kidney disease on dialysis.
- Parathyroid gland hyperplasia is the characteristic pathological finding.
Purpose of the Study:
- To investigate the morphological and ultrastructural features of parathyroid glands in patients with chronic kidney disease on dialysis.
- To assess the potential for DNA aneuploidy in these glands.
Main Methods:
- Histopathological examination of 98 surgically removed parathyroid glands (98 total parathyroidectomies, 7 subtotal).
- Ultrastructural analysis using electron microscopy on 75 glands.
- Flow-cytometric DNA analysis performed on 44 cases.
Main Results:
- All glands exhibited chief cell hyperplasia, predominantly nodular, with solid, trabecular, and follicular patterns observed.
- Ultrastructural study identified features like intermediate filaments, mitochondrial abnormalities, and multinucleation, with no distinct morphological differences between hyperplastic and adenomatous glands.
- Flow-cytometry revealed aneuploid DNA content in 27.2% of cases.
Conclusions:
- Parathyroid glands in dialysis patients show hyperplasia with varied patterns and ultrastructural features.
- No clear morphological distinction exists between hyperplastic and adenomatous glands in this cohort.
- A significant subset of these hyperplastic glands demonstrated DNA aneuploidy, warranting further investigation.