The parathyroid oxyphil cells.

A semi-quantitative study of the parathyroid oxyphil cells in over 500 cases is presented. They are divided into two age groups: under 45 years of age and over that age period. In the former group the oxyphil cells are few in number except in advanced renal disease when there is a gross increase; in one case the increase was at least 1,200-fold. Over 45 years of age there is an average increase but a considerable number of cases, including some in the ninth decade, show no significant increase. From approximately the middle of the fifth decade onwards the average increase is greater in females than males, roughly twice or even more for all decades. Although at all ages the greatest average increase occurs in cases showing azotaemia, other cases demonstrating either minimal or no significant histological evidence of chronic renal disease in routine histological sections show a considerable increase in oxyphil cells. It is postulated that the oxyphil cells are most likely called in to elaborate a hormone as a defence mechanism to maintain the equilibrium of certain as yet undetermined biochemical constituents. A plea is made for a more accurate assessment of these cells in various disease states. A simple method is outlined for making a quantitative assessment of the number of oxyphil cells.A preliminary investigation of the extent of proliferation of the oxyphil cells in various diseases strongly suggests that significant differences may be present. Finally attention is drawn to the fact that in the rare situation, but now likely to be more frequent, where a partial parathyroidectomy follows renal transplantation it will be possible to ascertain what happens to the oxyphil cells following relief of the azotaemic state. Correlation of the histological changes with alterations of electrolyte and acid base studies may well elucidate the significance of these cells.