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Functioning oxyphil cell adenoma in a patient with secondary hyperparathyroidism
J Misonou1, H Ishikura, M Aizawa
1Department of Pathology, Hokkaido University School of Medicine, Sapporo, Japan.
Acta Pathologica Japonica
|August 1, 1987
Summary
This study reports the first case of tertiary hyperparathyroidism caused by an oxyphil cell adenoma in a patient undergoing long-term hemodialysis. The adenoma produced parathyroid hormone (PTH), contributing to the condition.
Area of Science:
- Endocrinology
- Nephrology
- Pathology
Background:
- Secondary hyperparathyroidism is a common complication in patients with chronic renal failure undergoing long-term hemodialysis.
- Ectopic calcifying nodules and thoracic deformities can occur in severe cases.
Observation:
- A 45-year-old Japanese woman on hemodialysis for 13 years presented with ectopic calcifying nodules and thoracic deformity.
- Histopathological examination revealed parathyroid hyperplasia and an oxyphil cell adenoma in the left upper gland.
Findings:
- Immunohistochemical analysis showed that the oxyphil cells within the adenoma were strongly positive for parathyroid hormone (PTH).
- The study suggests continuous stimulation led to a functioning oxyphil cell adenoma capable of PTH production, alongside chief cell hyperplasia.
Implications:
- This case represents the first documented instance of tertiary hyperparathyroidism attributed to an oxyphil cell adenoma.
- Understanding the function of oxyphil and transitional oxyphil cells in parathyroid disease is crucial for managing complex cases.