title: Secondary parathyroid hyperplasia in tuberous sclerosis: report of a case with large eosinophilic ganglion-like cells similar to those of subependymal giant cell astrocytoma, tubers, and atypical angiomyolipoma.
abstract: We report a case of secondary parathyroid hyperplasia in a 49-year-old man with tuberous sclerosis. Two parathyroid glands had collections of large, eosinophilic ganglion-like endocrine cells that to our knowledge have not been previously described at this site. These cells are morphologically similar to those of subependymal giant cell astrocytoma, tubers, and atypical angiomyolipoma, all of which may arise in the setting of tuberous sclerosis. These large, eosinophilic ganglion-like cells found in different affected organs appear to be distinctive of tuberous sclerosis. We suggest these large eosinophilic cells arise from a common stem cell precursor that acquires variable phenotypes according to alterations in the cellular microenvironment.
authors.affiliation: Division of Anatomic Pathology, Department of Pathology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9073, USA.
authors.forename: Howard L
authors.initials: HL
authors.lastname: Martin
authors.forename: Edward
authors.initials: E
authors.lastname: Lee
authors.forename: Jorge
authors.initials: J
authors.lastname: Albores-Saavedra
mesh_terms: D018207:Angiomyolipoma / Q000378:metabolism / Q000473:pathology*; D001254:Astrocytoma / Q000378:metabolism / Q000473:pathology*; D014408:Biomarkers, Tumor / Q000378:metabolism; D001932:Brain Neoplasms / Q000378:metabolism / Q000473:pathology*; D003937:Diagnosis, Differential; D006801:Humans; D006965:Hyperplasia; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000378:metabolism; D010279:Parathyroid Diseases / Q000209:etiology / Q000378:metabolism / Q000473:pathology*; D010280:Parathyroid Glands / Q000378:metabolism / Q000473:pathology*; D011230:Precancerous Conditions / Q000378:metabolism / Q000473:pathology; D014402:Tuberous Sclerosis / Q000150:complications / Q000378:metabolism / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins