Quantitative ultrastructural and radioimmunologic assessment of parathyroid gland activity in primary hyperparathyroidism
Altenähr, E.; Arps, H.; Montz, R.; Dorn, G.
Laboratory Investigation; a Journal of Technical Methods and Pathology 41(4): 303-312
1979
ISSN/ISBN: 0023-6837 PMID: 491543 Document Number: 143000
The endocrine activity of parathyroid tumors is a function of the total tumor mass and the endocrine activity of all individual tumor cells. The neoplastic or hyperplastic parathyroid glands (PTG) of 23 patients with primary hyperparathyroidism (14 chief cell adenomas, 2 transitional oxyphil adenomas, 2 oxyphil adenomas and 5 primary chief cell hyperplasias) were studied by ultrastructural morphometry and compared to 10 normal human PTG removed at thyroid surgery. The tumor weights and morphometric data were compared to the preoperative concentrations of immunoreactive parathyroid hormone (IPTH). The chief cells of normal PTG showed a rather homogeneous organelle distribution. In chief cell adenomas the individual tumor was composed of chief cells with a rather uniform organelle pattern. All chief cell adenoma differences were considerable. This was also true of the other pathologic PTG lesions. In chief cell adenomas the tumor weight and the morphometric densities of the individual cytoplasmic compartments showed trends but no significant correlations with the preoperative serum IPTH concentrations. A composed morphometric index of weight and ultrastructural cytologic parameters correlated well (r = 0.95) with the serum IPTH; this index is not applicable to other parathyroid lesions. The negative correlations trend of the Golgi apparatus with serum IPTH concentrations in chief cell adenomas is discussed. An insufficiency of the Golgi apparatus to pack PTH to secretory or storage granules apparently exists in these adenomas resulting in an accelerated and uncontrolled release of PTH (or ProPTH) via a bypass. A cellular defect like this might be an important factor in the pathogenesis of primary hyperparathyroidism.