The pathologic assessment of primary hyperparathyroidism and its impact on therapy. A prospective evaluation of 50 cases with oil-red-O stain.

Normal and abnormal parathyroid glands removed surgically from 50 consecutive patients with primary hyperparathyroidism were studied by means of hematoxylin and eosin and oil-red-O stains. This was done to establish the incidence of the different pathological entities in our patient material, and to evaluate the role of the oil-red-O stain in the diagnostic histopathological process. The oil-red-O stain distinctly separates abnormally hyperfunctioning from normal or suppressed parathyroid tissue. Therefore, it is a valuable tool in the pathologic evaluation of patients with hyperparathyroidism. Chief cell adenomas were the most frequent lesions (88%), while diffuse hyperplasia was seen less commonly (10%) and carcinoma infrequently (2%). These findings justify a surgically conservative approach as the most desirable in managing patients with primary hyperparathyroidism.