Intrathoracic Hürthle cell (oxyphil cell) tumor of the thyroid.
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Humans↗
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Metachronous double parathyroid adenomas involving two different cell types: chief cell and oxyphil cell.
OBJECTIVE: To describe a patient with the rare occurrence of metachronous double parathyroid adenomas involving two different cell types. METHODS: We present a case report and a summary of the related literature. RESULTS: Double parathyroid adenomas are rare, occurring in 1.7 to 9% of patients with primary hyperparathyroidism. Most double parathyroid adenomas are synchronous lesions; few metachronous double parathyroid adenomas have previously been reported. Most parathyroid adenomas are of the chief cell variety, with oxyphil cell adenomas occurring in less than 1% of cases. In a 73-year-old man with no prior history or known family history of endocrine disease, primary hyperparathyroidism developed, and cervical ultrasonography demonstrated a mass in the right side of the neck. Subsequent parathyroidectomy revealed a right superior chief cell adenoma. Postoperatively, the patient's parathyroid hormone and serum calcium levels returned to normal and remained so for at least 9 years. Twelve years after the first operation, recurrent hyperparathyroidism prompted repeated surgical exploration of the neck, which disclosed a large left superior parathyroid mass. Surgical excision and histologic examination revealed the lesion to be an oxyphil cell adenoma. CONCLUSION: To our knowledge, this is the first reported case of metachronous double parathyroid adenomas involving two different cell types: chief cell and oxyphil cell.
Adenoma↗
Functioning oxyphil cell adenomas of parathyroid gland: immunoperoxidase evidence of hormonal activity in oxyphil cells.
Functional oxyphil adenomas of parathyroid gland are rare. Several studies have suggested that these tumors consist of a mixed cell population and that the transitional oxyphil cells and/or chief cells are the main source of parathormone, while the fully developed oxyphil cells have minimal or no hormonal activity. This report describes light, ultrastructural, and immunocytochemical features of six parathyroid adenomas, and confirms that these neoplasms are composed of a mixed cell population. It also demonstrates that the oxyphil cells have strong hormonal activity and therefore can play a significant role in the pathogenesis of hyperparathyroidism.
Adenoma↗
Parathyroid carcinoma of the oxyphil cell type. A report of two cases, light and electron microscopic study.
Parathyroid adenomas are subdivided into chief cell and oxyphil cell variants. However, the parathyroid carcinomas described thus far have been only of the chief cell type. Two cases of oxyphil cell carcinoma of the parathyroid gland are reported, with light and electron microscopic study. The patients presented apparent clinical hyperparathyroidism with x-ray finding of generalized fibrous osteitis and palpable parathyroid tumors. Initially, a pathologic diagnosis of parathyroid adenoma was made in both of them. However, in due course, pulmonary metastases developed in one patient and a local recurrence occurred in the other, 5 and 8 years after the primary operation, respectively. Review of the microscopic slides showed that both primary tumors met the criteria of parathyroid carcinoma. A matter of interest in both cases is that the neoplasms were composed principally of oxyphil cells. Electron microscopic study confirmed the existence of typical oxyphil cells packed with numerous mitochondria.
Adenoma↗
Oxyphil cells in a red-tailed hawk (Buteo jamaicensis) with nutritional secondary hyperparathyroidism.
A captive, immature red-tailed hawk (Buteo jamaicensis) was presented with multiple long-bone fractures, a serum calcium of 7.9 mg/dl, and a history of being fed an all-meat diet. Gross and microscopic examinations of the parathyroid glands revealed marked glandular hypertrophy and the presence of interlacing cords and clusters of light chief cells and oxyphil cells in approximately equal numbers. Bone sections showed severe fibrous osteodystrophy. These findings support the observation that the oxyphil cell is a product of continued stimulation, and they suggest that hypocalcemia may be a stimulating factor.
Animals↗
Parathyroid gland adenoma in primary hyperparathyroidism: report of two cases--chief and oxyphil cell adenoma.
Parathyroid adenomas are classified into two types: chief cell and oxyphil cell variants. In this report two types of parathyroid adenoma in association with hyperparathyroidism were examined. Both cases had suffered from renal calculi, and underwent operation. The laboratory tests showed high serum calcium and parathyroid hormone (PTH) levels. An exploratory surgery revealed a solitary tumor in each case. After extirpation of the parathyroid tumor these data returned to normal values. Electronmicroscopically, oxyphil cell adenoma in this report was characterized by numerous mitochondria and annulate lamellae in the cytoplasm. In some tumor cells secretory-like granules were observed.
Adenoma↗
Functioning oxyphil cell adenoma of the parathyroid gland: evidence for parathyroid secretory activity of oxyphil cells.
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Adenoma↗
The eosinophilic cells of the parathyroid (oxyphil cells), salivary (oncocytes), and thyroid (Huerthle cells) glands. Light and electron microscopic observations.
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Adenolymphoma↗
Oxyphil cell function in secondary parathyroid hyperplasia.
Oxyphil cell function in secondary parathyroid hyperplasia due to chronic renal failure was evaluated using in situ hybridization and heterotransplantation of parathyroid tissue. In situ hybridization and histologic analysis were performed on continuous frozen sections using 22 parathyroid tissues. A restricted area composed exclusively of oxyphil cells was observed in 10 specimens, and an area of only chief cells was found in 12 specimens. Silver grains demonstrating the existence of parathyroid hormone (PTH) mRNA were 18.8 +/- 7.8 (mean +/- SD) in oxyphil cells while those in chief cells were 17.2 +/- 7.5. PTH mRNA was abundant in both the oxyphil and chief cells. Further analysis of oxyphil cell function was assessed by the heterotransplantation of parathyroid nodules, consisting exclusively of oxyphil or chief cells, into nude mice. The function of these implants was assessed by measuring the concentration of human intact PTH which did not cross-react with mouse PTH. Serum PTH concentrations were correlated with the volume of implanted tissue. Elevations of PTH concentrations were similar in the mice transplanted with oxyphil or chief cells, indicating that both cell types had similar PTH secretory activity. The basic histologic characteristics of both cell types were not altered following transplantation. These results demonstrate that oxyphil cells in secondary parathyroid hyperplasia synthesize and secrete PTH, and that this secretion contributes to the pathophysiology of hyperparathyroidism.
Alkaline Phosphatase↗
[Oxyphilic cell and clear cell carcinoma of the thyroid].
Oxyphilic cell (Hürthle cell) carcinomas of the thyroid gland, variant of follicular carcinoma, are more malignant than follicular non oxyphilic cell carcinomas with a similar size and degree of invasiveness. Gross features, microscopic features of oxyphilic, clear and bicolored cells carcinomas and diagnostic techniques are related with a differential diagnosis with papillary oxyphilic cell carcinoma.
Adenocarcinoma, Clear Cell↗
Oxyphil cell adenoma and hyperparathyroidism.
Although the oxyphil cells of the human parathyroid generally are not thought to be involved in the secretion of parathyroid hormone, there have been numerous reports in the literature describing functional oxyphil cell adenomas. We reviewed 453 consecutive parathyroid explorations in 446 patients over a 13-year period and identified 15 patients whose hyperparathyroidism had been caused by adenomas composed almost exclusively of oxyphil cells. All patients were relieved of their hypercalcemia postoperatively, and there have been no recurreness during a mean follow-up of 40 months (100% follow-up). Three patients have died, all without evidence of recurrent hyperparathyroidism at the time of death. Immunoperoxidase and ultrastructural studies confirm that oxyphil cells from these adenomas contain parathyroid hormone and suggest that they are capable of secretory activity. A review of the literature showed that functional oxyphil adenomas occur more frequently than is usually appreciated, although they are an uncommon cause of primary hyperparathyroidism.
Adenoma↗
Mitochondrial adenosine triphosphatase in the oxyphil cells of a renal oncocytoma.
Oxyphil cells are characterized by cytoplasm packed with large numbers of mitochondria. Study of these unusual cells may provide information about the regulation of mitochondrial biogenesis. Although it has been suggested that this is a compensatory proliferation due to a mitochondrial dysfunction, no such dysfunction has been well documented. In this study we considered the possibility of dysfunction in the mitochondrial enzyme F1/Fo-adenosine triphosphatase(ATPase) as a stimulating factor involved in the mitochondrial proliferation of oxyphil cells. Mitochondria isolated from frozen tissue of a renal oncocytoma showing structural integrity and purity by electron microscopy were studied. Submitochondrial particles formed by sonic disruption showed the presence of the F1 component of mitochondrial ATPase with electron microscopy which was functionally active. The oligomycinsensitive ATPase activity from the renal oncocytoma was 0.133 mumol/min.mg submitochondrial particle protein which was higher than the readings obtained from normal kidney tissue (0.091 mumol/min.mg SMP protein) obtained from hamsters. Normal human renal tissue obtained at autopsy contained only nonfunctional mitochondria and therefore could not be used as control tissue. Mitochondrial ATPase dysfunction does not appear to be the inciting factor in the proliferation of mitochondria seen in oxyphil cell metaplasia and future studies should consider other possibilities. Preliminary functional studies of this nature can be performed with properly prepared frozen surgical tissue.
Adenoma↗
[Oxyphil cell adenomas associated with primary hyperparathyroidism (author's transl)].
Almost all functioning parathyroid adenomas are composed of chief or water-clear cells. In contrast, most oxyphil cell adenomas of this organ remain clinically silent. To date only occasional parathyroid adenomas consisting of oxyphil cells only have been found associated with primary hyperparathyroidism. The two additional examples described in this report confirm observations by others indicating that the parathyroid oxyphil cell can play an active metabolic role.
Adenoma↗
The parathyroid oxyphil cells.
A semi-quantitative study of the parathyroid oxyphil cells in over 500 cases is presented. They are divided into two age groups: under 45 years of age and over that age period. In the former group the oxyphil cells are few in number except in advanced renal disease when there is a gross increase; in one case the increase was at least 1,200-fold. Over 45 years of age there is an average increase but a considerable number of cases, including some in the ninth decade, show no significant increase. From approximately the middle of the fifth decade onwards the average increase is greater in females than males, roughly twice or even more for all decades. Although at all ages the greatest average increase occurs in cases showing azotaemia, other cases demonstrating either minimal or no significant histological evidence of chronic renal disease in routine histological sections show a considerable increase in oxyphil cells. It is postulated that the oxyphil cells are most likely called in to elaborate a hormone as a defence mechanism to maintain the equilibrium of certain as yet undetermined biochemical constituents. A plea is made for a more accurate assessment of these cells in various disease states. A simple method is outlined for making a quantitative assessment of the number of oxyphil cells.A preliminary investigation of the extent of proliferation of the oxyphil cells in various diseases strongly suggests that significant differences may be present. Finally attention is drawn to the fact that in the rare situation, but now likely to be more frequent, where a partial parathyroidectomy follows renal transplantation it will be possible to ascertain what happens to the oxyphil cells following relief of the azotaemic state. Correlation of the histological changes with alterations of electrolyte and acid base studies may well elucidate the significance of these cells.
Adenoma↗
The oxyphil cell in abnormal parathyroid glands. A study of 114 cases.
The parathyroid oxyphil cell is apparently capable of parathyroid hormone secretion. To investigate the significance of oxyphil cells in abnormal human parathyroid glands, we compared histologic and clinical features in a retrospective study of 114 cases of hyperparathyroidism, Parathyroid glands were classified by the presence or absence of significant numbers of oxyphil cells. Significant numbers of oxyphil cells were found in 91% of all cases of secondary hyperparathyroidism, 69% of all cases of single adenoma, and 55% of all cases of primary multiple-gland hyperparathyroidism. Oxyphil cells are more common in women. Among cases of primary multiple-gland hyperparathyroidism, oxyphil cells were associated with greater mean serum calcium levels (P = .003). The oxyphil cell of the parathyroid gland is associated with hyperparathyroidism, and may secrete more hormone than the chief cell.
Adult↗
Thyroglobulin synthesis of oxyphilic cells in various types of neoplastic and autoimmune thyroid diseases.
To determine the content of thyroglobulin in oxyphilic cells of the thyroid, which have been considered as non-thyroglobulin producing cells, the degree of stainability of the various oxyphilic cells for thyroglobulin was compared with that of non-oxyphilic follicular cells in either same or different lesion. A total of 13 oxyphilic lesions, including three follicular adenomas containing oxyphilic cell nodules, four pure oxyphilic cell adenomas, and six Hashimoto's thyroiditis were compared with 16 of non-oxyphilic lesions such as, seven follicular adenomas, four chronic lymphocytic thyroiditis, and five Graves' disease. Many oxyphilic cells stained positively for thyroglobulin regardless of their morphologic variation, but less intensely than the usual follicular cells in follicular adenomas, chronic lymphocytic thyroiditis, and Graves' disease. The stainability of oxyphilic cells for thyroglogulin did not show any significant correlation with morphologic features, whereas in follicular adenomas, the non-oxyphilic follicular cells forming microfollicles stained less strongly for thyroglobulin than the same cells lining large mature follicles in a reproducible way. With above findings, we concluded that oxyphilic cells maintain the functional activity in terms of thyroglobulin synthesis, although the content of the thyroglobulin is less than that of non-oxyphilic colloid forming follicular cells.
Adenoma↗
Functioning oxyphil cell adenoma in a patient with secondary hyperparathyroidism.
A 45-year-old Japanese woman who has been receiving haemodialysis for 13 years suffered from an ectopic calcifying nodule and deformity of the thorax. She was diagnosed as hyperparathyroidism secondary to chronic renal failure. Total parathyroidectomy was performed, and the excised parathyroid glands showed hyperplasia in four and an adenoma in the left upper gland. On the electron microscopic study, the adenoma was composed of oxyphil cells and transitional oxyphil cells, the latter predominating in number. It was revealed from immunohistochemical study that the oxyphil cells in adenoma were strongly stained for parathyroid hormone (PTH). Continuous stimuli to secrete PTH seemed to generate the functioning oxyphil cell adenoma with an ability of PTH production, as well as hyperplasia of parathyroid chief cells. It seems to be the first case of tertiary hyperparathyroidism caused by an oxyphil cell adenoma. Functions of oxyphil cells and transitional oxyphil cells are briefly discussed.
Adenoma↗
Oxyphilic cell variant of endometrioid adenocarcinoma.
A case of oxyphilic cell variant of endometrioid adenocarcinoma is presented. To the best of our knowledge, there have been only three such cases reported in the English literature. The patient was a 35-year-old Japanese female (gravida 0, para 0). She was slightly obese with profuse vaginal bleeding. Histological examination of the resected uterus revealed endometrioid adenocarcinoma with an exclusive oxyphilic cell component. There was no evidence of myometrial invasion nor lymph node metastases. Reported cases of oxyphilic cell variant of endometrioid adenocarcinoma, including the present case, were stages 0-1 and grades 1-2. Although further study is necessary to evaluate this variant, oxyphilic cell variant seems to be an early stage of adenocarcinoma and should be differentiated from eosinophilic metaplasia and other types of adenocarcinoma of the endometrium.
Adenocarcinoma↗