Optical and ultrastructural morphology in hyperparathyroidism during dialysis

: Twenty-six cases of surgically removed parathyroid glands in patients under chronic dialytic treatment were studied. In 19 cases a total parathyroidectomy was performed while in the remaining 7 cases only a subtotal parathyroidectomy was possible. All parathyroid glands (98) showed chief cells hyperplasia, with nodular pattern in 24 patients and diffuse pattern in two cases. A solid pattern was observed in 79 parathyroid glands, a trabecular in 49 and a follicular one in 33. Ultrastructural study was performed on 75 parathyroid glands. Electron microscopy has been useful in the evaluation of functional status of the single cell and in the detection of some morphological features (i.e., presence of intermediate filaments in the cytoplasms, mitochondrial abnormalities, multinucleation), rarely observed in hyperplasia and more frequent in adenoma. No morphologic differences have been found between hyperplastic glands and adenomatous glands. In the 27.2 per cent (out of 44 cases) flow-cytometric DNA analysis showed an aneuploid DNA content.