[Parathyroidectomy and autotransplantation in renal hyperparathyroidism. I. Morphologic studies for tissue selection].
During total parathyroidectomy and autotransplantation 140 enlarged glands were removed in 35 hemodialyzed patients (normocalcemic: n = 14; hypercalcemic: n = 21). The cross-sections of all glands were classified intraoperatively. Diffuse hyperplastic (type 1) and nodular hyperplastic (type 2) glands could be distinguished. Using a stereo-magnifier (magnification: x 10 -x 16), type 1a- (stromal fat cells!) and type 1b- glands (without stromal fat cells!) could be differentiated. Those areas were also found between the nodules of type 2-glands. Significantly, nodular hyperplastic glands predominated in hypercalcemic patients (chi 2-Test: p less than 0.001). The colour of the nodules on the cross-sections of type 2-glands correlated with the predominating cell type ("dark": nodule of oxyphile cells; "medium": nodule of chief cells; "light": nodule of 'degenerating' oxyphile cells). As sign of proliferation the mitotic index was elevated (greater than 1:10,000) in type 1b-glands, in type 1b-like areas and in nodules of type 2-glands. These areas should not be used for autotransplantation.
Niederle
B
B
I. Chirurgische Universitätsklinik Wien.
Hörandner
H
H
Roka
R
R
Woloszczuk
W
W
D000273:Adipose Tissue / Q000473:pathology; D002118:Calcium / Q000097:blood; D006085:Graft Survival; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000473:pathology / Q000601:surgery*; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000473:pathology; D008854:Microscopy, Electron; D008940:Mitotic Index; D010280:Parathyroid Glands / Q000473:pathology / Q000601:surgery / Q000637:transplantation*
D002118:Calcium
Parathyreoidektomie und Autotransplantation beim renalen Hyperparathyreoidismus. I. Morphologische Untersuchungen zur Gewebeauswahl.