158b PTH histo/path Flashcards
PT embryogensis?
upper pair - 4th branchial cleft
lower pair - 3rd branchial cleft
PT migtation can cause what?
aberrant locations
mediastinum, carotid sheath, behind esophagus
where are the PT located? blood supply? nerves nearby?
posterior of thyroid
inferior thyroid artery from subclavian
superior thyroid artery from external carotid
recurrent laryngeal nerve to vocal cord?
PT principle cell?
chief cell with PTH
round nuclei at center of cell
oxyphil cell
in PT
larger than chief cells
granular eospinophilic cytoplasm from increaesd mitochondria –> pink and clustered
no secretory granulees –> adenoma isn’t functioning
what causes primary hyperPT?
adenoma - most common
hyperplasia
carcinoma - least common
what does hyper PT cause?
hypercalcemia
secondary hyperPT causes?
intestinal disease/renal disease –> hypocalcemia –> excess PTH
reversible with normal kidney function
tertiary hyperPT?
autononmous PT after treatment –> hypercalcemia
what inherited tumor sydnromes can cause hypterPT?
MEN-1
MEN-2A
most cases are sporadic though
clinical features of hyper PT?
Stones (renal), bones, moans (GI tract), psychic groans
hypercalcemia –> nephrolethiasis
GI –> ulcers, pancreattitis, gall stones
psychic –> leathargy, seizures, depressions
bone –> osteoporosis, brown tumor
bone manifestiations of P-hpt?
loss of bone –> osteoporesis
osteitis fibrosa cystica –> holes in bone
subperiosteal resorption
brown tumor
where do pt adenoma present other than the pt gland?
thymus in antirior mediastunium
PT Adenoma
unilaterla
solid - uniform without fat
variety of appearances –> can appear like a thyroid follicular adenoma/carcinoma
PT carcinoma
rare,
invasion
cytologic atypia is NOT diagnostic
bone disease
