Parathyroiditis.Parathyroiditis is a rare and poorly understood condition. Chronic parathyroiditis may occur in patients with hypoparathyroidism Hypoparathyroidism Definition Hypoparathyroidism is the result of a decrease in production of parathyroid hormones by the parathyroid glands located behind the thyroid glands in the neck. The result is a low level of calcium in the blood. , as well as in those with primary chief-cell hyperplasia. Most patients are asymptomatic. Antibodies to parathyroid parathyroid /par·a·thy·roid/ (-thi´roid) 1. situated beside the thyroid gland. 2. see under gland. par·a·thy·roid adj. 1. tissue are seen in only a few cases of parathyroiditis. It is thought that parathyroiditis represents an autoimmune process similar to thyroid gland Hashimoto's disease. The presence of seronegative seronegative /se·ro·neg·a·tive/ (-neg´ah-tiv) showing negative results on serological examination; showing a lack of antibody. se·ro·neg·a·tive adj. cases of parathyroiditis does not rule against an autoimmune etiology, because a similar phenomenon is observed in Hashimoto's thyroiditis. Based on this assumption, it is believed that the lymphocytic infiltration is an ongoing destructive process. Parathyroiditis is characterized by a slightly enlarged gland, although the macroscopic appearance is not specific. Histologically, aggregates of mature lymphocytes are seen infiltrating otherwise normal parathyroid tissue (figure, A). There is often lymphoid follicle formation with prominent germinal centers (figure, B). Plasma cells and fibrosis (often heavy) may be identified, and destruction of the parenchyma Parenchyma A ground tissue of plants chiefly concerned with the manufacture and storage of food. The primary functions of plants, such as photosynthesis, assimilation, respiration, storage, secretion, and excretion—those associated with living has been reported. Atrophy of the residual parathyroid tissue may also be seen. More than one parathyroid gland may be involved, although multifocal multifocal /mul·ti·fo·cal/ (mul?te-fo´k'l) arising from or pertaining to many foci. mul·ti·fo·cal adj. Relating to or arising from many foci. disease is seen in the presence of autoimmune disorders, such as Sjogren's disease. [FIGURE A-B OMITTED] A chronic inflammatory proliferation may occur as a nonspecific reaction in patients with various infectious disease processes; however, such infiltrates are usually sparse and have a perivascular perivascular /peri·vas·cu·lar/ (-vas´ku-lar) near or around a vessel. perivascular around a vessel. perivascular cellulitis distribution. Lymphoma involving the parathyroid glands (as part of systemic disease) with distinctive morphologic features has been reported, but it is extremely rare. The significance of parathyroiditis is unknown, and its management is supportive if clinically necessary. Suggested reading Bondeson AG, Bondeson L, Ljungberg O. Chronic parathyroiditis associated with parathyroid hyperplasia and hyperparathyroidism. Am J Surg Pathol 1984:8:211-15. Lloyd RV. Douglas BR, Young WF, Jr. Endocrine Diseases. Atlas of Nontumor Pathology. 1st series, fascicle fascicle /fas·ci·cle/ (fas´i-k'l) 1. a small bundle or cluster, especially of nerve, tendon, or muscle fibers. 2. a tract, bundle, or group of nerve fibers that are more or less associated functionally. I. Washington D.C.: Armed Forces Institute of Pathology Armed Forces Institute of Pathology A section of the US military which provides consultations, reference atlases and educational programs for pathologists , 2002:61-2. Lester D.R. Thompson, MD From the Department of Pathology, Woodland Hills Medical Center, Southern California Permanente Medical Group, Woodland Hills, Calif. |
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