Human parathyroid gland: a freeze fracture and thin section study

Parathyroid glands in chronic aluminum intoxication

In chronic renal failure, aluminum overload may influence parathyroid function. In a study of possible aluminum-induced parathyroid abnormalities, parathyroid glands from nine parathyroidectomized patients on hemodialysis were examined by light and electron microscopy and by X-ray microanalysis. Aluminum overload was assessed by the presence of stainable aluminum (aluminum surface, 23.3% +/- 11% of total surface) in bone biopsy specimens. The mean plasma aluminum concentration was 7.7 +/- 1.9 mumol/L. All patients but one had elevated plasma concentrations of immunoreactive parathyroid hormone as well as osteitis fibrosa. The aluminum concentrations in bone and parathyroid gland from these patients were significantly higher than those in tissue from patients on hemodialysis without stainable bone aluminum. Abundant aluminum deposits were present in parathyroid chief cell cytoplasm in lipoid bodies, lipofuscin granules, and mitochondria. These cells exhibited features of active hormonal synthesis and contained numerous secretory granules. The data show that in the parathyroid glands of these aluminum-intoxicated patients the presence of aluminum deposits neither induced cellular damage or chief cell necrosis nor interfered with the production of parathyroid hormone.

Parathyroid cell variants may be provoked during immersion fixation

Parathyroid glands of cattle, dogs, cats, mice and rats were immersed in glutaraldehyde or mixtures consisting of glutaraldehyde, formaldehyde and acrolein in either Na-phosphate, Na/K-phosphate or Na-cacodylate buffer, and postfixed with OsO4 in the same buffers or, alternatively, in s-collidine. Excellent preservation of bovine, feline and murine parathyroid glands was achieved with fixation mixtures containing 1% glutaraldehyde, 1.5-2% formaldehyde and 2.5-5% acrolein in 0.1 M Na-cacodylate with or without Ca2+ and Mg2+, Na-phosphate or Na/K-phosphate at 4 degrees C followed by postfixation with 1% OsO4 in the same buffers or in s-collidine containing sucrose, Ca2+ and Mg2+. This procedure largely abolished the occurrence of parathyroid cell variants. Bovine parathyroid glands were also satisfactorily preserved with 1% glutaraldehyde and 2% formaldehyde whereas 1% glutaraldehyde and 2.5 or 5% acrolein, lower or higher buffer osmolarity, or immersion at room temperature led to vacuolization of RER and to breakdown of membranes. In contrast, all fixation protocols led to the formation of dark and light cell variants and to multinucleated syncytial cells in dog and rat parathyroids. The results thus show that parathyroid cell variants arise during immersion fixation and that aldehydes, buffers and temperature are important factors for provoking parathyroid cell variants.

Parathyroid glands in primary hyperparathyroidism: an ultrastructural study of 50 cases

Parathyroid glands from 50 cases of primary hyperparathyroidism were examined by light and electron microscopy in an attempt to elucidate the diagnostic role of electron microscopy in this disease. In the cases in which only one gland was removed at surgery, a final diagnosis by light microscopy was not possible. The electron microscopic findings for some of these single glands (e.g., ribosomal-lamellar complexes and groups of centrioles) suggested that they were adenomas. In cases in which two or more enlarged glands were removed, a correct final diagnosis could be made on the basis of the light microscopic findings alone, and electron microscopy provided no further significant information. Where one enlarged gland and one normally sized gland were removed, electron microscopy disclosed important findings in the normally sized glands. Specifically, light microscopic examination of normally sized glands suggested endocrine suppression, while electron microscopy showed chief cell activity, thereby changing the final diagnosis from adenoma to hyperplasia. The clinical follow-up assessment in some of these patients confirmed the electron microscopic findings. Therefore, the incidence of adenoma in patients with primary hyperparathyroidism should be critically re-evaluated by ultrastructural studies of the normal glands that should be removed with the enlarged ones.

Human parathyroid antigen: characterization and localization with monoclonal antibodies

A cell surface antigen on human parathyroid cells was identified by monoclonal antibodies. The antigen, called parathyroid antigen (PTA), is found on both of two major polypeptides (190 kDa and 160 kDa) apparently associated exclusively with parathyroid cells. To determine whether PTA was a suitable target for in vivo imaging, 125I-labeled anti-PTA was injected into nude mice bearing human parathyroid xenografts. IgG1 anti-PTA antibody showed excellent radiolocalization of the grafts, whereas IgM anti-PTA, containing the same variable domains as the IgG1 antibody, showed little specific binding. These results suggest that antibody isotype is an important parameter for the in vivo immunoscintigraphy of specific cellular antigens.

RER-associated structure in parathyroid glands removed because of tertiary hyperparathyroidism

We have performed a submicroscopic analysis of the parathyroid glands removed from 2 patients with tertiary hyperparathyroidism. In both cases an RER-associated structure was found, which has never been described in normal or pathologic conditions in protein-secreting cells. This finding was present in only one of the glands of each patient. Their morphologic features are described. The significance of this structure is also discussed.

Acute hyperparathyroidism. Clinical, laboratory and ultrastructural findings in a variant of primary hyperparathyroidism

In a series of 6 patients out of 47 cases with extrarenal hyperparathyroidism we investigated the clinical, laboratory and ultrastructural peculiarities of acute hyperparathyroidism. It was found that there are characteristic differences between both entities which, however, are fluid. Clinically more severe were neuromuscular psychiatric and mental signs. In the laboratory parameters PTH determined by radioimmunoassay and calcium were higher whereas hemoglobin was lower. The weights of the adenomas did not differ in both groups and this was also true for light microscopy findings. Electron microscopy revealed accelerated hormone extrusion and autodigestion of retrived membrane material in the cases of acute hyperparathyroidism similar to characteristics of parathyroid cells stimulated by hypocalcemia in tissue culture.