PARATHYROID NODULES IN A PATIENT WITH CHRONIC-RENAL-FAILURE - HYPERPLASIA OR NEOPLASIA

Enlarged parathyroid glands found at autopsy in a 69-year-old-old man with chronic renal failure and hyperparathyroidism were examined and c ompared with his parathyroidectomy specimens from 5 years previously. Histology, immunohistochemistry, and DNA analysis did not discriminate conclusively between nodular hyperplasia and adenoma. Although transf ormation of parathyroid hyperplasia to adenoma remains an attractive h ypothesis, conclusive distinction between dependent secondary hyperpar athyroidism and autonomous tertiary hyperparathyroidism cannot be made at present on the basis of morphology.