PTH Adenoma
Normal Parathyroid
Primary Hyperparathyroidism
Parathyroid adenomas are •
mostly composed of fairly
uniform, polygonal chief cells
with small, centrally placed
nuclei
Primary parathyroid hyperplasia •
usually involves all 4 glands (up
to 1 gm total). It is composed of
chief cells and can be sporadic
or associated to MEN
In parathyroid hyperplasia, there is little or no adipose tissue, but any or all cell types
normally found in parathyroid are present.
Note the pink oxyphil cells here.
This is actually "secondary hyperparathyroidism" with enlarged glands as a
consequence of chronic renal failure with impaired phosphate excretion.
The increased serum phosphate tends to drive serum calcium down, which in turn
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drives the parathyroids to secrete more parathyroidhormone.
Parathyroid hyperplasia is shown here.
Three and one-half glands have been removed (only half the gland at the
lower left is present).
Parathyroid hyperplasia is the second most common form of primary
hyperparathyroidism, with parathyroid carcinoma the least common form.
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From AAFPweb
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Zona Glomerulosa •
Zona Fasiculata •
Zona Reticularis
•
Massive adrenal
haemorrhage, resulting in
primary acute adrenal
insufficiency
Metastatic breast
carcinoma affecting the
adrenal gland and causing
primary chronic adrenal
insufficiency
This is a caseating granuloma of tuberculosis in the adrenal gland.
Tuberculosis used to be the most common cause of chronic adrenal
insufficiency.
Now, idiopathic (presumably autoimmune) Addison's disease is much more
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often the cause for chronic adrenal insufficiency.
Adrenal Cortical Adenoma
Adrenal Adenoma
Cortical Carcinoma
Adrenal Carcinoma