Chief cell intracytoplasmic fat used to evaluate parathyroid disease by frozen section

The chief cells of parathyroid adenomas were found to contain less intracytoplasmic fat than normal parathyroid glands and/or the adjacent rims of nonadenomatous parathyroid tissue. The amount of sudanophilic material in the chief cells was relatively uniform for each individual adenoma, but varied between patients. In half of the patients with parathyroid adenomas, Sudan-positive granules were generally absent from the adenomatous cells, whereas in the other half the granules were easily identifiable. The chief cells of secondary hyperplasia showed a less uniform pattern in each gland. In some areas, the stain for intracellular fat was negative, while adjacent cells contained prominent Sudan-positive granules. These findings suggest that staining frozen sections for intracellular fat is a useful but limited aid in the differentiation of parathyroid adenomas from normal parathyroid gland tissue.