title: Morphological evaluation of parathyroid adenomas and immunohistochemical analysis of PCNA and Ki-67 proliferation markers.
abstract: OBJECTIVE
  Parathyroid adenomas are the most common cause of primary hyperparathyroidism. Biological studies have shown that parathyroid adenomas are monoclonal proliferations. Up to date, five cell types have been identified in normal parathyroid tissues; chief cells, vacuolated chief cells, dark chief cells, oxyphil cells and transitional oxyphil cells. Most parathyroid adenomas are predominantly composed of chief cells. In this study, we aimed to indicate the relationship between the predominant cell type in parathyroid adenomas and proliferating cell nuclear antigen, Ki-67 antigen, and serum parathormone levels and the gland weight.
  
  
  METHODS
  15 cases who had a diagnosis of parathyroid adenomas were included in the study. Histopathologically, the predominant cell type was determined in all the cases. Paraffin blocks were immunohistochemically stained with proliferating cell nuclear antigen and Ki-67.
  
  
  RESULTS
  The average parathormone level of the cases was 239.52 ± 36.61 pg/ml before surgery. Mean gland weight was 1.69 ± 0.49 g. Two of the cases showed atypical adenoma characteristics. The predominant cell type was vacuolated chief cell. Immunohistochemical investigation showed that the mean average Ki-67 index value was 4.26 ± 0.86%. The mean proliferating cell nuclear antigen index was 93.20± 45.72/10³. There was a meaningful relationship between gland weights and serum parathormone levels. There was no meaningful relationship between predominant cell types and serum parathormone levels, proliferating cell nuclear antigen index, and Ki-67 index. The chief cell was identified as the predominant cell type.
  
  
  CONCLUSIONS
  It can be concluded that parathyroid adenomas come into existence as a result of neoplastic proliferation of chief cells, especially vacuolated chief cells.
authors.affiliation: Department of Pathology, Başkent University, Faculty of Medicine, Ankara, Turkey. ebrudemiralay@yahoo.co.uk
authors.forename: Ebru
authors.initials: E
authors.lastname: Demıralay
authors.forename: Gülüm
authors.initials: G
authors.lastname: Altaca
authors.forename: Beyhan
authors.initials: B
authors.lastname: Demırhan
mesh_terms: D000236:Adenoma / Q000097:blood / Q000737:chemistry* / Q000473:pathology / Q000601:surgery; D000368:Aged; D001706:Biopsy; D049109:Cell Proliferation; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis*; D008875:Middle Aged; D009929:Organ Size; D010280:Parathyroid Glands / Q000737:chemistry* / Q000473:pathology / Q000601:surgery; D010281:Parathyroid Hormone / Q000097:blood; D010282:Parathyroid Neoplasms / Q000097:blood / Q000737:chemistry* / Q000473:pathology / Q000601:surgery; D018809:Proliferating Cell Nuclear Antigen / Q000032:analysis*; D014421:Turkey
chemical_list: D019394:Ki-67 Antigen; C470125:PTH protein, human; D010281:Parathyroid Hormone; D018809:Proliferating Cell Nuclear Antigen