[Morphological aspects of parathyroid hyperplasia in patients with chronic renal insufficiency on dialysis]

The authors present an anatomic study of parathyroid hyperplasia in 15 patients presenting chronic renal failure treated by hemodialysis (mean time 6 years). The light microscopic examination (n = 56) confirms diffuse hyperplasia so occur in patients submitted to dialysis for a period inferior to 4 years while nodular hyperplasia occurs in patients submitted to dialysis for longer a time. Mixed hyperplasia may be considered a transitional form between diffuse and nodular hyperplasia. Electron microscopic examination (n = 31) reveals the secretory ability of chief cells containing lots of secretory granules, and the energetic power of oxyphil cells filled with mitochondria. The great amount of oxyphil and of vacuolized cells after long periods of dialysis means degenerative transformation of ancient chiefs cells. The authors emphasize the interest of per-operative identification of the type of hyperplasia in order to choose the fitting procedure of parathyroidectomy.