Histopathological diagnosis of hyperparathyroidism

In the histopathological diagnosis of parathyroid gland pathology there has been a lack of well defined and generally acceptable criteria for differentiating between a normal and a slightly hyperplastic gland, and in many cases also between an adenoma and hyperplasia. This has meant that the histological evaluation of the parathyroid tissue has often been subjective depending on individual assessment of different pathologists. In recent years research in this area has yielded experience which should contribute towards a more reliable diagnosis. Two methods - the determination of the glandular parenchymal cell mass and the evaluation of the intracellular fat content - have been found to be particularly important in the histological diagnosis. The present paper describes the histology of normal and abnormal parathyroid glands and the application of parenchymal cell mass estimation and intracellular fat staining do assist diagnosis.