Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0221002 (primary hyperparathyroidism)
 4,921 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Parathyroid carcinoma is a very rare disease occurring in less than 2-3% of all the cases showing clinical features of primary hyperparathyroidism. Several histological markers have been used for distinguishing between benign and malignant tumors of the parathyroid glands. However, most of these markers are not easily applicable and clinical prognosis cannot be predicted by histopathological criteria alone. A recent study has drawn attention to the role of the cell cycle associated antigen Ki-67 detected by MIB-1 monoclonal immunocytochemistry in parathyroid tumors: in fact, Ki-67 seems to be a valuable marker of malignancy in such tumors since it permits an easy detection of proliferating and dividing cells. Here we report in detail a case of severe recurrent hyperparathyroidism in a 51-year-old female patient undergoing regular hemodialysis treatment. In the surgical specimens of the parathyroid glands, the tumor proliferative fraction of 56, expressed as the number of Ki-67-positive nuclei per thousand cells, and the mean mitosis count of 0.5, expressed as the percentage of the total amount of Ki-67 positive nuclei, support the diagnosis of parathyroid carcinoma despite the scanty amount of microscopical signs considered characteristic of malignancy, i.e. extensive thick fibrous bands or prominent nucleoli. To our knowledge this paper is the first clinical report that supports the diagnostic role of the cell cycle associated antigen Ki-67 in parathyroid carcinoma in a case of secondary hyperparathyroidism in a patient undergoing hemodialysis.
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PMID:Recurrent secondary hyperparathyroidism due to parathyroid carcinoma: usefulness of Ki-67 immunostaining in the diagnosis of a malignant parathyroid tumor. 895 8

A retrospective study on 22 cases of parathyroid adenoma, 9 cases of primary parathyroid hyperplasia and 14 specimens of normal suppressed glandular tissue was undertaken to determine the usefulness of proliferative index (PI) for discriminating adenoma from hyperplasia, as an adjunct to the existing histological criteria. PI was determined by avidin-biotin-complex immunostaining after high temperature microwave antigen retrieval in paraffin sections, using monoclonal MIB-1 antibody which detects paraffin resistant analogue of cell cycle-associated Ki-67 antigen. PI expressed as percentage positive cell nuclei, was 1.36 +/- 0.62 (range 0.04-2.72) in adenoma, 1.17 +/- 0.83 (0.02-1.98) in hyperplasia and 0.03 +/- 0.02 (0.00-0.06) in normal suppressed glandular tissue. While the difference between normal suppressed glandular tissue and adenoma and hyperplasia was significant (P < 0.001), that between adenoma and hyperplasia was not. We conclude that although PI could distinguish between normal suppressed glandular tissue versus glands with primary hyperparathyroidism, it failed as an additional useful parameter for discriminating between adenoma and hyperplasia, both of which have low but similar proliferative activity.
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PMID:MIB-1 proliferative index in parathyroid adenoma & hyperplasia. 918 80

The most interesting aspects of parathyroid disease are the increased incidence of primary hyperparathyroidism, which nowadays is diagnosed more and more frequently through the casual discovery of hypercalcaemia, the various diagnostic methodologies used, the ongoing debate as to the function of parathyroidectomy in asymptomatic patients and the new video-assisted surgical techniques which have recently been developed. The authors retrospectively review 31 consecutive cases of primary hyperparathyroidism. The clinical onset was characterised in 26 cases by an osteoarthralgic syndrome associated with renal and biliary pathology. Five cases were asymptomatic. Prior to surgery, all patients underwent both biochemical and instrumental tests. MIB scintigraphy was found to yield the most reliable diagnosis, leading to identification of 83.6% of diseased parathyroids. As regards surgical treatment, 29 cases were treated with a simple parathyroidectomy, 1 with a bilateral inferior parathyroidectomy and 1 with a thyroid lobectomy. Associated thyroid surgery was performed in 8 cases for concomitant thyroid disease: 1 total thyroidectomy, 2 subtotal thyroidectomies and 5 lobectomies. In 3 cases radioimmunoguided surgery was used. There were no cases of mortality, and 9.6% of patients presented specific morbidity characterised by some degree of paraesthesia. As stated by other researchers, the authors argue that MIBI scintigraphy is the most reliable test for the diagnosis of hyperparathyroidism and that surgical treatment is the first choice for symptomatic primary hyperparathyroidism. The surgical strategy depends on the abnormality underlying the hyperparathyroidism: in the event off an adenoma, a bilateral exploration of the neck and removal of the diseased parathyroid are required; in the case of hyperplasia, a subtotal parathyroidectomy is necessary with marking of the residual parathyroid which will simplify any possible reoperation; in the event of carcinoma, a thyroid loboisthmectomy and ipsilateral parathyroidectomy are performed with removal of the fatty tissue of the antero-superior mediastinum and ipsilateral cervical functional lymphadenectomy.
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PMID:[Primary hyperparathyroidism: diagnostic and therapeutic trends]. 1158 66