Enlarged parathyroid glands found at autopsy in a 69-year-old-old man with chronic renal failure and hyperparathyroidism were examined and compared with his parathyroidectomy specimens from 5 years previously. Histology, immunohistochemistry, and DNA analysis did not discriminate conclusively between nodular hyperplasia and adenoma. Although transformation of parathyroid hyperplasia to adenoma remains an attractive hypothesis, conclusive distinction between dependent secondary hyperparathyroidism and autonomous tertiary hyperparathyroidism cannot be made at present on the basis of morphology.
Keywords: Adenoma; Hyperparathyroidism; Parathyroid Gland; Parathyroid Tissue; Primary Hyperparathyroidism.