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Presented by Pedram Argani, M.D. and prepared by Justin Poling, M.D.
Case 1: This is a 57 year old female with hypercalcemia.
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Question 1 of 1
1. Question
Week 517: Case 1
This is a 57 year old female with hypercalcemia.images/jsp6252012/case1_2x.jpg
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images/jsp6252012/case1_20x_2.jpgCorrect
Answer: Parathyroid adenoma
Histology: This is cellular glandular tissue composed predominantly of small tubules. The nuclei are hyperchromatic and relatively small, with condensed chromatin. The tubules are small and contain eosinophilic luminal secretions. There is no evidence of calcium oxalate crystal deposition. There are foci of marked cytologic atypia scattered throughout glands, but no evidence of capsular or vascular invasion, or dissecting fibrous bands which would suggest the diagnosis of parathyroid carcinoma.
Discussion: Parathyroid carcinoma typically demonstrates mitotic activity, vascular and/or capsular invasion, dissecting fibrous bands, and trabecular growth. Thyroid lesions have follicles which are lined by cells with more open chromatin, and the follicles frequently have calcium oxalate crystals present within them. Thyroid follicles are typically larger than those of the parathyroid.
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Answer: Parathyroid adenoma
Histology: This is cellular glandular tissue composed predominantly of small tubules. The nuclei are hyperchromatic and relatively small, with condensed chromatin. The tubules are small and contain eosinophilic luminal secretions. There is no evidence of calcium oxalate crystal deposition. There are foci of marked cytologic atypia scattered throughout glands, but no evidence of capsular or vascular invasion, or dissecting fibrous bands which would suggest the diagnosis of parathyroid carcinoma.
Discussion: Parathyroid carcinoma typically demonstrates mitotic activity, vascular and/or capsular invasion, dissecting fibrous bands, and trabecular growth. Thyroid lesions have follicles which are lined by cells with more open chromatin, and the follicles frequently have calcium oxalate crystals present within them. Thyroid follicles are typically larger than those of the parathyroid.
