Misonou J, Ishikura H, Aizawa M, Ohira S
Department of Pathology, Hokkaido University School of Medicine, Sapporo, Japan.
Acta Pathol Jpn. 1987 Aug;37(8):1357-66. doi: 10.1111/j.1440-1827.1987.tb00468.x.
A 45-year-old Japanese woman who has been receiving haemodialysis for 13 years suffered from an ectopic calcifying nodule and deformity of the thorax. She was diagnosed as hyperparathyroidism secondary to chronic renal failure. Total parathyroidectomy was performed, and the excised parathyroid glands showed hyperplasia in four and an adenoma in the left upper gland. On the electron microscopic study, the adenoma was composed of oxyphil cells and transitional oxyphil cells, the latter predominating in number. It was revealed from immunohistochemical study that the oxyphil cells in adenoma were strongly stained for parathyroid hormone (PTH). Continuous stimuli to secrete PTH seemed to generate the functioning oxyphil cell adenoma with an ability of PTH production, as well as hyperplasia of parathyroid chief cells. It seems to be the first case of tertiary hyperparathyroidism caused by an oxyphil cell adenoma. Functions of oxyphil cells and transitional oxyphil cells are briefly discussed.
一名45岁的日本女性，已接受血液透析13年，患有异位钙化结节和胸廓畸形。她被诊断为继发于慢性肾衰竭的甲状旁腺功能亢进。进行了甲状旁腺全切术，切除的甲状旁腺中四个显示增生，左上腺有一个腺瘤。电子显微镜研究显示，腺瘤由嗜酸性细胞和过渡性嗜酸性细胞组成，后者数量居多。免疫组织化学研究表明，腺瘤中的嗜酸性细胞甲状旁腺激素（PTH）染色强烈。持续分泌PTH的刺激似乎产生了具有PTH分泌能力的功能性嗜酸性细胞腺瘤以及甲状旁腺主细胞增生。这似乎是首例由嗜酸性细胞腺瘤引起的三发性甲状旁腺功能亢进病例。文中简要讨论了嗜酸性细胞和过渡性嗜酸性细胞的功能。
