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PubMed1999

Bilateral coronoid process hyperplasia with limitation on mouth opening: case report.

Coronoid process hyperplasia with limitation of mouth opening is rare. The pathology is often ignored, but it can be easily detected using dental panoramic view of x-ray films. Definition of the coronoid process hyperplasia can be made by measuring the height of coronoid process and the ratio of coronoid/condyle height on lateral cephalometric x-ray film. Etiology of the coronoid process hyperplasia can be congenital or acquired. Differentiation of the diagnosis may be difficult. The congenital type occurs at early age with clinical manifestations. Proposed hypotheses for the formation of coronoid process hyperplasia include increased activity within the temporalis muscle from conditions such as functional stress, compression, and tension. For patients with coronoid process hyperplasia and restriction on mouth opening, conservative treatment should first be attempted. Surgical treatment is considered if conservative treatment fails. Coronoidectomy with early mobilization and aggressive physiotherapy corrects the problem. We present a patient with coronoid process hyperplasia with limitation of mouth opening who was successfully treated.

Abnormalities, Multiple↗
PubMedDate not supplied

Retrospective analysis of 29 patients surgically treated for hepatocellular adenoma or focal nodular hyperplasia.

BACKGROUND/AIMS: Hepatocellular adenoma resection and focal nodular hyperplasia supervision are widely recognized as the best management when these benign liver tumors are diagnosed. Differential diagnosis is thus mandatory. METHODOLOGY: Twenty-nine patients with a presumed benign liver tumor were retrospectively analyzed. RESULTS: Histopathological analysis of these resected liver tumors demonstrated hepatocellular adenoma in 16 patients and focal nodular hyperplasia in 13. One hepatocellular carcinoma was disclosed into a hepatocellular adenoma and 2 hepatocellular adenoma showed foci of liver-cell dysplasia. Seven patients with hepatocellular adenoma (43%) had evidence of intratumoral hemorrhage, among which 3 patients were admitted with intraperitoneal tumoral rupture. Computed tomography, performed in 26 patients, was the most reliable examination to characterize these presumed benign liver tumors. Magnetic resonance imaging concerned only 5 patients but 3 hepatocellular adenoma and 1 focal nodular hyperplasia were diagnosed. The indications of focal nodular hyperplasia surgical resection were chronic pain (4 pts), hepatocellular adenoma diagnosis (4 pts), undeterminate liver mass (2 pts), a liver mass of unknown origin in patients with a neoplastic history (3 pts). A diagnosis of focal nodular hyperplasia assumed by the imaging work-up was always histologically confirmed. All the patients underwent hepatic resection with no mortality. CONCLUSIONS: This report underlines the risk of hemorrhage or malignant transformation of hepatocellular adenoma that justifies a safety surgical resection. An imaging work-up in favor of focal nodular hyperplasia allows radiological observation.

Adenoma, Liver Cell↗
PubMed1975

Primary hyperplasia of the parathyroids.

Eight cases of primary hyperplasia of the parathyroid are reported among 322 cases of primary hyperparathyroidism. Preoperatively, all had high serum calcium. Six cases were water-clear, one chief cell, and one mixed hyperplasia. The case of chief cell hyperplasia was misdiagnosed primarily as adenoma. Its exact nature was recognised retrospectively. Identification and biopsy with frozen section of all the parathyroid glands is stressed. This is essential to rule out the presence of multiple adenoma or adenomatous formation in hyperplasia. When hyperplasia was proved, total parathyroidectomy and autotransplantation of parathyroid tissue equivalent to 1/2 or one normal-sized parathyroid gland was done in 7 cases. Although one patient had hyperplastic tissue in situ, the results of this management are considered to be satisfactory. On to six years postoperatively, all surviving patients are without symptoms of hyperparathyroidism and have normal serum calcium. Two patients required a small dose of Vit D-2 to sustain a normal calcium level. Total parathyroidectomy and autotransplantation of parathyroid tissue (PTA) is preferred to subtotal parathyroidectomy in cases of primary hyperplasia. There is a good primary result and reoperation can be easily done if there is recurrence of hyperparathyroidism.

Adult↗
PubMed2001

DNA image cytometry in the differential diagnosis of endometrial hyperplasia and adenocarcinoma.

OBJECTIVE: To test the value of DNA image cytometry in the differential diagnosis of hyperplastic endometrial lesions and endometrial carcinoma on a series of 153 cases of simple hyperplasia (n = 71), complex hyperplasia (n = 28), complex atypical hyperplasia (n = 11) and endometrial adenocarcinoma (n = 43). STUDY DESIGN: Monolayer smears were prepared from three 50-micron-thick sections by a cell separation technique and were stained according to Feulgen. The DNA content of 250 epithelial cells, chosen randomly, was determined using a TV image analysis system (CM-1, Hund, Wetzlar, Germany). The DNA content of 30 lymphocytes served as an internal standard for the normal diploid value in every case. Different DNA cytometric parameters and the mean nuclear area were calculated. RESULTS: Cases of adenocarcinoma and complex atypical hyperplasia (n = 54) were defined as clinically "positive" as these patients are normally treated by hysterectomy. The remaining cases of simple and complex hyperplasia (n = 99) were interpreted as clinically "negative" as conservative therapy is usually preferred. Requesting a specificity of > 90%, high sensitivity rates were calculated for ploidy imbalance (94%), mean ploidy (91%), diploid deviation quotient (91%), DNA stemline ploidy (87%) and 2c deviation index (85%), based on suitable thresholds. Entropy (76%), 5c exceeding events (63%), mean nuclear area (48%) and 9c exceeding events (6%) revealed lower sensitivity values. 5c Exceeding events (P = .0117) and mean nuclear area (P = .0392) were helpful in differentiating between atypical hyperplasia and endometrial carcinoma as the data distribution was significantly different with the U test. CONCLUSION: Our results indicate that DNA single cell cytometry is a highly relevant tool in the differential diagnosis of endometrial lesions and could be used as a complementary diagnostic method, especially in histomorphologically difficult cases.

Adenocarcinoma↗
PubMed2000

Benign prostatic hyperplasia. The Saudi perspective in the year 2000.

All published data on benign prostatic hyperplasia in Saudi Arabia was reviewed. The age of presentation of the benign prostatic hyperplasia Saudi patient is between 60 and 70 years. Until the introduction of medical therapy for benign prostatic hyperplasia, presentation by complication was common, mainly by retention of urine in 40-50% of the cases. Diagnostic modalities are improving and both biochemical and imaging techniques are now available. Medical therapy for benign prostatic hyperplasia is widely used but studies on only 2 alpha adrenergic blocking agents out the 5 pharmacological preparations currently in the field were reported. Those are Prazosin and Terazosin. Several studies on the use of the 5-alpha reductase enzyme inhibitor Finastride were also reported. Minimally invasive surgery, other recent techniques including laser technology and standard surgical techniques such as open prostatectomy and Trans-urethral Resection of the Prostate are reported to be efficiently utilized. The workload due to benign prostatic hyperplasia is increasing and estimated currently to be 20-40% of the whole urological workload. Late and complicated presentations still pose a serious medical problem. Screening programs and enhancement of awareness are required to ensure early presentation. The diagnostic modalities have improved and need to further improve by making both PSA testing and ultrasonography as standard procedures. Most advanced methods of medical and surgical treatment are available. More studies researching all aspects of benign prostatic hyperplasia are needed to improve patient care.

5-alpha Reductase Inhibitors↗
PubMed1975

Relationship of hyperplasia to cancer in 3-methylcholanthrene-induced mammary tumorogenesis.

Light microscopic study of the evolution of 3-methylcholanthrene-induced mammary tumors in Wistar-Furth rats revealed a seriation of changes proceeding from early hyperplasia (8 days) to advanced hyperplasia (57 days) and cancer (78 days). Ultrastructurally, cellular changes in advanced hyperplasia and cancer were indistinguishable, being characterized by nuclear chromatin clumping, prominent nucleoli, cytoplasmic polyribosomal aggregates and pseudopodal extensions, and prominent Golgi structures. These features, as well as the lack of limiting lamina basalia, allowed for their distinction from the cells of early hyperplasia. Further, only nodules of both advantanced hyperplasia and cancer were transplantable in syngeneic recipients. Chromosomal aberrations were qualitatively similar in cells obtained from all lesions but were progressively more frequent. Although these findings do not allow for the discrimination of advanced hyperplasia and cancer, they indicate their close pathogenetic relationship as well as the very early occurrence of chromosomal alterations in the development of mammary cancer in this model system.

Animals↗
PubMed2001

A model for the study of cystic endometrial hyperplasia in bitches.

The aims of this study were: (i) to establish a reliable model for the study of cystic endometrial hyperplasia in ovariectomized bitches; and (ii) to assess the roles of oestrogen and progesterone in the pathogenesis of irritant-induced cystic endometrial hyperplasia. Greyhound bitches (n = 15) were ovariectomized and divided into five groups (n = 3 per group). After 3-4 weeks, oestradiol benzoate (0.6-4.8 micrograms kg-1, i.m.) was administered twice a day for 12 days to the bitches in group 1, followed by progesterone (0.2-1.8 mg kg-1, i.m.) twice a day for 30-33 days. These dosages were chosen to mimic the plasma hormone concentrations of a normal oestrous cycle. A silk suture was inserted by laparotomy into the left uterine horn 12 days into the simulated dioestrus (determined by vaginal cytology) and necropsy was performed after a further 12 days. For groups 2-5, the silk suture was positioned at ovariectomy. After a further 3-4 weeks, these bitches were treated with progesterone (group 2: 1.8 mg kg-1 i.m. twice a day), oestradiol benzoate (group 3: 0.6-4.8 micrograms kg-1 i.m. twice a day), oestradiol benzoate and progesterone together (group 4: previous dosages) or vehicle (group 5). Necropsies were performed after 12-13 days of treatment. Cystic endometrial hyperplasia was induced in the suture-containing uterine horns of all bitches in groups 1 and 4, and in two bitches in group 2. Cystic endometrial hyperplasia did not develop in any control (no suture) uterine horns, or in either uterine horn of the bitches treated with either oestradiol only or vehicle. These results indicate that progesterone is necessary for the development of irritant-induced cystic endometrial hyperplasia and that oestradiol potentiates the effects of progesterone. The protocol used for bitches in group 1 would be a suitable model for further studies of the pathogenesis of cystic endometrial hyperplasia.

Animals↗
PubMedDate not supplied

Enlarged focal nodular hyperplasia of the liver under the influence of oral contraceptives.

Two cases of focal nodular hyperplasia of the liver in mature women treated with the oral contraceptive are described. Radiological investigations in one case revealed the typical findings of focal nodular hyperplasia with computed tomography and magnetic resonance imaging demonstrating central scar structures while spoke-wheel appearance was evident on arteriography, in the other case however findings were atypical. Routine investigations including liver function tests and alpha-fetoprotein levels were normal while hepatitis B surface antigen and hepatitis C virus antibody were negative. The lesions of these two cases enlarged significantly during the follow-up and they were therefore surgically resected. Pathological features of both resected specimens, such as hepatocellular hyperplasia, bile duct proliferation and vascular abnormalities, were compatible with focal nodular hyperplasia. It has been suggested that tumor growth may be augmented by sex hormone stimulation and therefore estrogen and progesterone receptor expressions in the resected tumors were determined by immunocytochemistry. Interestingly, stainings for both receptors were negative. In case 2, the tumor was enlarging although oral contraceptive use had been discontinued for the past 7 years. These results suggest that there is no direct relationship of focal nodular hyperplasia with oral contraceptives. The role of sex hormones in focal nodular hyperplasia of the liver merits further study.

Adult↗
PubMed2001

[Histone H3 gene expression level as markers of hyperplasia simplex of endometrium].

SUBJECT: The excessive proliferative activity of endometrial cells drives to hyperplasia, via states: simplex hyperplasia, complex and atypical hyperplasia, and finally preneoplastic state may arise. New molecular markers and their ability to differentiate physiological and pathological states are described. DESIGN: The aim of this study was to evaluate the usefulness of histone H3 gene expression level as a marker of hyperplasia of endometrium. MATERIAL AND METHODS: The level of H3 mRNA was estimated using RT-QPCR method in proliferative phase (n = 5) and endometrial hyperplasia simplex (n = 8). Differences in expression level of H3, were evaluated by Student's t-test (t-test for independent samples). RESULTS: In our experiments the average mRNA H3 expression was significantly higher(p < 0.05, p = 0.03) in case of hyperplasia simplex in comparison to H3 expression in proliferative state of endometrium. CONCLUSION: The results confirm advantage of estimation of H3 mRNA level as a marker of cell proliferation in endometrium.

Adult↗
PubMed2003

Production of interleukin 15 by human colon cancer cells is associated with induction of mucosal hyperplasia, angiogenesis, and metastasis.

PURPOSE: The purpose of this study was to identify a mediator produced by human colon cancer cells that is responsible for the induction of hyperplasia in the adjacent mucosa. EXPERIMENTAL DESIGN: Seventy human colon cancer surgical specimens were immunostained to determine the presence of cytokines that can induce hyperplasia in the adjacent mucosal. Human colon cancer cells with low and high metastatic potential were implanted into the cecal wall of nude mice. The resulting lesions were studied by immunohistochemistry to detect possible mediators of mucosal hyperplasia. RESULTS: Immunostaining of 70 colon cancer specimens from 70 patients suggested that mucosal hyperplasia and distant metastasis were associated with the expression of interleukin (IL)-15 and, to a lesser extent, transforming growth factor alpha. The production of IL-15 by colon cancer cells was not associated with the infiltration of natural killer cells into the tumors. Cecal tumors produced in nude mice by human colon cancer cells with low and high metastatic potential (KM12C and KM12SM cells, respectively) expressed similar levels of transforming growth factor alpha, and expression of IL-15 was detected only in the metastatic KM12SM cells and was associated with hyperplasia of the surrounding mucosa. The expression of the IL-15 receptor in rat intestinal epithelial cells (IEC6 cells) was confirmed by immunoblotting with antibodies against IL-15 receptor alpha and IL-2 receptor beta and gamma subunits and by a binding assay using (125)I-labeled IL-15 (K(d) = 0.011 nM). IL-15 stimulated proliferation of the IEC6 cells, even under serum starvation. Treatment of IEC6 cells with IL-15 decreased doxorubicin-mediated cytotoxicity. In IEC6 cells treated with either IL-15- or KM12SM-conditioned medium, immunoblotting revealed a decrease in the production of p21Waf1, Bax, and Bak and an increase in the production of cyclin E, proliferating cell nuclear antigen, the phosphorylated active form of AKT, basic fibroblast growth factor, and vascular endothelial growth factor, changes associated with cell growth, survival, and induction of angiogenesis. CONCLUSIONS: These data indicate that IL-15 produced by metastatic colon carcinoma cells can induce hyperplasia in the mucosa adjacent to colon cancer, thus contributing to angiogenesis and progression of the disease.

Animals↗
PubMedDate not supplied

Detection of the draining vein from hepatic focal nodular hyperplasia on three-dimensional computed tomography.

It is sometimes difficult to differentiate focal nodular hyperplasia from other hepatic tumors. A report is presented of a patient in whom three-dimensional computed tomography was useful to diagnose focal nodular hyperplasia of the liver. In a 31-year-old women with epigastralgia, ultrasonography and computed tomograms showed a tumor in the liver. Three-dimensional computed tomograms showed a hypervascular lesion with a hypodense interior and feeding arteries on early images. On delayed images, a draining vein connecting with the hepatic vein was clearly demonstrated. Although focal nodular hyperplasia was strongly suspected, the tumor was resected because of the enlargement and extrahepatic growth of the tumor. Pathologic examination showed that the tumor was focal nodular hyperplasia of the liver. A draining vein connecting to the hepatic vein may be a characteristic of focal nodular hyperplasia. Three-dimensional computed tomography may be useful to diagnose focal nodular hyperplasia of the liver.

Adult↗
PubMedDate not supplied

Contrast-enhanced, wide-band phase-inversion power Doppler imaging of hepatic focal nodular hyperplasia.

BACKGROUND/AIMS: To determine whether examination of hepatic focal nodular hyperplasia by wide-band, phase-inversion sonography offers any advantages over power and color Doppler sonography in the depiction of specific characteristics of these pathologies. METHODOLOGY: Twenty-six patients were examined. The presence of focal nodular hyperplasia was confirmed by ultrasound-guided biopsy, surgical resection, dynamic helical computed tomography or magnetic resonance. All patients, prior to enhanced sonography, had undergone B-mode gray-scale sonography, color Doppler, and power Doppler examinations. After injection of 2.5 g of Levovist intravenously, analysis of the contrast agent arrival was performed by wide-band, phase-inversion power Doppler sonography. RESULTS: The B-mode gray-scale sonography, color and power Doppler sonography were non-specific for focal nodular hyperplasia in 14 cases in our examination. However based on the wide-band, phase-inversion power Doppler sonography findings all patients with focal nodular hyperplasia were diagnosed. All typical anatomic features of focal nodular hyperplasia such as "star sign" or "spoke-wheel" pattern were clearly visible. In 3 cases, computed tomography and magnetic resonance imaging had failed to disclose pathology while phase-inversion sonographic images were completely suggestive which was later finally confirmed by histologic examination. CONCLUSIONS: Our data demonstrate the usefulness of wide-band, phase-inversion power Doppler sonography in the differential diagnosis of hepatic focal nodular hyperplasia by visualizing all characteristic anatomic details.

Adult↗
PubMed2006

[Clinical analysis of reactive thymic hyperplasia following chemotherapy for childhood malignant lymphoma].

BACKGROUND & OBJECTIVE: Reactive thymic hyperplasia following chemotherapy for malignant tumors is likely to be misdiagnosed as tumor residue or relapse, therefore, leads to unnecessary treatment. This study was to analyze the clinical features of reactive thymic hyperplasia following chemotherapy for childhood malignant lymphoma. METHODS: Clinical data of 13 children with reactive thymic hyperplasia following chemotherapy for malignant lymphoma, treated from Mar. 1999 to Mar. 2004, were retrospectively analyzed. Of the 13 cases, 5 were Hodgkin's disease (HD), and 8 were non-Hodgkin's lymphoma (NHL). All patients received computed tomography (CT) to evaluate the therapeutic effect. When a new thymic mass emerged, positive electron tomography/computed tomography (PET/CT) was performed to identify its quality. RESULTS: At diagnosis, 10 patients had mediastinal involvement. Reactive thymic hyperplasia occurred following the completion of chemotherapy in 9 cases, or during the maintenance of chemotherapy in 4 cases. CT showed that the longest diameters of the new mediastinal masses were 2.2-6.0 cm (mean 3.7 cm). The interval from last chemotherapy cycle to the occurrence of thymic hyperplasia was 2-12 months (mean 4 months). PET/CT was performed to 5 cases, and showed no vital tumors in the mediastinum. Three cases were misdiagnosed as tumor residue or relapse, and received second-line therapy. All patients were followed-up for 1-6 years (median 4 years), and none suffered tumor relapse. CONCLUSIONS: Reactive thymic hyperplasia may occur following intensive chemotherapy for childhood malignant lymphoma. It should not be misdiagnosed as malignant tumors and overtreated.

Adolescent↗
PubMed1991

[A comparison between hyperplasia of ductal epithelium and mucin producing tumor of the pancreas].

A comparison between papillary proliferation of the ductal epithelium with goblet cell metaplasia (Hyperplasia) and mucin producing tumor (MPT) of the pancreas was studied clinicopathologically. Hyperplasia was found in 35 out of 56 autopsied cases (62.5%) and revealed an age-related frequency. Hyperplasia was situated chiefly in the branches of pancreatic duct, whereas MPT in both the main and branches of pancreatic duct. The ducts with hyperplasia frequently contained secretions in their lumens and were found in the proximity of isolated islets of Langerhans, while MPT consisted of high columnar and mucin producing cells, arranged in cyst-papillary pattern, filled with mucin and accompanied by disappearance of the surrounding parenchyma. Both Hyperplasia and MPT were frequently occurred in an elderly age group. Therefore, papillary hyperplasia of the ductal epithelium with goblet cell metaplasia and mucin producing tumor showed similar appearance, except for cellular atypism.

Adenocarcinoma, Mucinous↗
PubMed2006

[Sporadic C-cell hyperplasia associated with multinodular goiter].

INTRODUCTION: C cell hyperplasia may arise in a familial setting, associated to MEN2 syndromes, or sporadic, associated to other thyroid diseases. Its prevalence in the sporadic form, as well as its biological significance, need to be determined to date. Sporadic C cell hyperplasia may be associated to elevated serum calcitonin levels, and routinary calcitonin screening tests on the search of early medullary carcinomas, have born to an increase of its diagnosis. MATERIALS AND METHODS: We report herein the case of a 47-years old female, submitted to total thyroidectomy for nodular goiter, with slightly increased serum calcitonin levels and positive pentagastrin test. Familial history was negative for endocrinopathies. CASE REPORT: Histological examination revealed in the setting of a multinodular goiter, the occurrence of C cell hyperplasia, demonstrated by means of calcitonin immunoistochemistry, in the absence of foci of medullary carcinoma. Morphological features (no atypia) were consistent with a sporadic physiologic form of C cell hyperplasia, as opposed to neoplastic C cell hyperplasia in the context of MEN2. DISCUSSION: The prevalence of C cell hyperplasia is not well defined, and differently from the familial form, its progression to sporadic medullary carcinoma should still be proven. Therefore its observation in a sporadic form, as in the present case, do not modify the clinical and therapeutic approach in affected patients.

Calcitonin↗
PubMed1976

The role of ACTH in the episodic release of aldosterone in patients with idiopathic adrenal hyperplasia, hypertension, and hyperaldosteronism.

The relationship of plasma aldosterone concentration to its identified stimuli was examined in three patients with hypertension, hyperaldosteronism, and idiopathic adrenal hyperplasia. Four patients with hyperaldosteronism due to adrenal adenomas served as controls. Plasma aldosterone, cortisol, sodium, and potassium concentrations and renin activity were measured in blood samples taken at 20 minute intervals from 2 A.M. to 8 A.M. during recumbency and sleep. The tests were performed on all patients following a regular sodium diet both before and after short-term treatment with dexamethasone. Two of the three subjects with adrenal hyperplasia were re-examined after 2 weeks of dexamethasone therapy. All four control patients with adenomas had episodic increases of plasma aldosterone which were significantly correlated with those of plasma cortisol (r = +0.48 to +0.90). This confirms the previously reported relationship between aldosterone and ACTH in such patients. Two patients with idiopathic adrenal hyperplasia had a similar secretion pattern and a highly significant correlation of the two hormones (r = +0.76 and +0.77); one did not (r = 0.13). Short-term dexamethasone pretreatment attenuated the episodic release pattern and partially suppressed the mean plasma concentrations of aldosterone in the four patients with an adenoma and in the two patients with idiopathic hyperplasia whose plasma aldosterone and cortisol concentrations were positively correlated. There was no such effect in the third patient. The first two patients with idiopathic hyperplasia were subsequently retested following 2 weeks of dexamethasone treatment to determine if the episodic secretion pattern of plasma aldosterone would correlated with other stimuli following this period of ACTH suppression. One showed little change from the pattern observed after short-term glucocorticoid treatment. The second had a similarly blunted aldosterone response until ACTH secretion led to a resumption of episodic changes in plasma aldosteerone concentrations. These data indicate that ACTH frequently is the dominant stimulus of the episodic secretion of aldosterone in patients with either adrenal adenomas or hyperplasia. When ACTH is suppressed, the hypersecretion of aldosterone is presumably sustained by an intrinsic adrenal abnormality or by an as yet unidentified stimulus.

Adenoma↗
PubMed1991

[Cases of endometrial hyperplasia diagnosed at a regional hospital in the Province of Pavia].

Two hundred and fourteen cases of endometrial hyperplasia were diagnosed at the Hospital of Casorate (USSL 77, Pavia) between 1 january 1984 and 31 december 1989. Cases were subdivided as follows: 60 glandular hyperplasias, 54 glandular cystic hyperplasias, 83 adenomatous glandular hyperplasias, 13 atypical glandular hyperplasias and 24 cases of endometrial cancer. The analysis of data shows an increase in hyperplasia, but only the adenomatous and atypical varieties have a potentially carcinomatous evolution.

Endometrial Hyperplasia↗
PubMed1990

[A clinico-pathologic study of 31 cases of parathyroid hyperplasia and tumours].

31 cases of primary hyperplasia and neoplasms of the parathyroid gland are reported. Among them, 23 cases were parathyroid adenoma, 6 cases parathyroid hyperplasia, one case adenoma associated with hyperplasia, and one case of parathyroid adenocarcinoma. Follow-up study demonstrated that prognosis in the adenoma group is better than that in the hyperplasia group, and one carcinoma patient died from metastasis. Regarding differential diagnosis, adenoma is usually single, with frequent presence of oppressed parathyroid tissue next to the tumor capsule; and cell atypical hyperplasia is often seen microscopically, which is usually multiple in sites, and some residual adipose tissue can be found under the microscope. Clinically, both groups manifested hypercalcemia and hypophosphatemia, especially in those cases with chief cell hyperplasia. Capsule infiltration and vascular embolism are emphasized as the differential features between benign and malignant parathyroid tumours.

Adenocarcinoma↗