title: Incidence of parathyroid glands located in thymus in patients with renal hyperparathyroidism.
abstract: BACKGROUND
  Parathyroid glands are frequently located in thymus, and it is essential to resect thymic tissue from the neck incision, especially in surgery for renal hyperparathyroidism (HPT).
  
  
  METHODS
  In this study, we evaluated the incidence, location, and type of intrathymic parathyroid glands in 902 patients who underwent initial parathyroidectomy (PTx) for advanced renal HPT in our department. Removal of the thymic tongues on both sides was routinely performed from the neck incision, and the thymic tissue was carefully examined both macroscopically and microscopically.
  
  
  RESULTS
  Of the 902 patients in the study, 269 had only inferior parathyroid glands in the thymus, in 62 patients only supernumerary glands were found in the thymic tongue, and in 78 patients both inferior and supernumerary glands were present in thymic tissue. Therefore the incidence of patients with intrathymic glands was 45.3% (269 + 62 + 78 = 409/902). In 129 (92.1%) of 140 patients with supernumerary glands in the thymic tongue, these glands were detected only on histopathological examination, and about half of them were classified as the parathyromatosis type.
  
  
  CONCLUSIONS
  In the human, parathyroid glands might be located in the thymus in about 50%. If the inferior gland/glands cannot be found around the inferior pole of thyroid lobe, it is very important to search for glands in the thymic tongue. Moreover, to avoid missing supernumerary glands, removal of the thymic tongue on both sides is essential in surgery for renal HPT.
authors.affiliation: Department of Transplant and Endocrine Surgery, Nagoya Daini Red Cross Hospital, Nagoya, 4668650, Japan.
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Uno
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Tominaga
authors.forename: Susumu
authors.initials: S
authors.lastname: Matsuoka
authors.forename: Toyonori
authors.initials: T
authors.lastname: Tsuzuki
authors.forename: Shuichi
authors.initials: S
authors.lastname: Shimabukuro
authors.forename: Tetsuhiko
authors.initials: T
authors.lastname: Sato
authors.forename: Norihiko
authors.initials: N
authors.lastname: Goto
authors.forename: Takaharu
authors.initials: T
authors.lastname: Nagasaka
authors.forename: Akio
authors.initials: A
authors.lastname: Katayama
authors.forename: Kazuharu
authors.initials: K
authors.lastname: Uchida
mesh_terms: D000368:Aged; D002828:Choristoma / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications* / Q000473:pathology / Q000601:surgery; D015994:Incidence; D008206:Lymphatic Diseases / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands; D016105:Parathyroidectomy; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D013950:Thymus Gland
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