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Related Concept Videos

The Parathyroid Glands00:59

The Parathyroid Glands

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The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
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The endocrine system produces and secretes hormones, which interact with the skeletal system. These hormones control bone growth, maintain bone once it is formed, and remodel it.
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Calcitonin, a vital polypeptide hormone, regulates calcium levels within body fluids. It is released by the parafollicular cells, also known as C cells, situated in the follicular epithelium of the thyroid gland. Calcitonin responds to fluctuations in blood calcium levels and the influence of gastrointestinal hormones like gastrin and cholecystokinin.
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The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
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Tumor progression is a phenomenon where the pre-formed tumor acquires successive mutations to become clinically more aggressive and malignant. In the 1950s, Foulds first described the stepwise progression of cancer cells through successive stages.
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Advances and Updates in Parathyroid Pathology.

Hamza N Gokozan1, Theresa Scognamiglio

  • 1Department of Pathology and Laboratory Medicine, New York Presbyterian Hospital, Weill Cornell Medicine, New York, NY.

Advances in Anatomic Pathology
|October 31, 2022
PubMed
Summary

This review updates the diagnosis and classification of parathyroid lesions, incorporating recent molecular and clinical advances. It emphasizes using immunohistochemistry and molecular studies to refine the diagnosis of endocrine disorders like hyperparathyroidism.

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Area of Science:

  • Endocrinology and Pathology
  • Molecular Biology
  • Oncology

Background:

  • Hyperparathyroidism, a common endocrine disorder, presents with elevated parathyroid hormone and hypercalcemia, classified into primary, secondary, and tertiary types.
  • Primary hyperparathyroidism, often sporadic, manifests pathologically as adenoma, hyperplasia, or carcinoma.
  • Recent insights into parathyroid disease pathogenesis have refined diagnosis and classification.

Approach:

  • Correlating clinical, radiologic, and laboratory findings with pathologic features is crucial for distinguishing hyperparathyroidism types.
  • The World Health Organization (WHO) now uses 'primary hyperparathyroidism-related multiglandular parathyroid disease' for multiglandular hyperplasia.
  • Nomenclature updates include 'atypical parathyroid tumor' to denote uncertain malignant potential.

Key Points:

  • Identifying familial disease features aids pathologists in management.
  • Ancillary immunohistochemistry and molecular studies are valuable for classifying parathyroid neoplasms.
  • Parafibromin serves as a diagnostic and prognostic marker for atypical parathyroid tumors and carcinomas.

Conclusions:

  • This review updates the diagnosis and classification of parathyroid lesions based on molecular and clinical advancements.
  • It highlights the utility of ancillary immunohistochemical and molecular studies in refining parathyroid lesion diagnosis.
  • Accurate classification of parathyroid neoplasms is essential for appropriate patient management.