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Immunohistochemistry in Diagnostic Parathyroid Pathology

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Abstract

Pathologists are usually readily able to diagnose parathyroid tissues and diseases, particularly when they have knowledge of the clinical information, laboratory findings, and radiographic imaging studies. However, the identification of parathyroid tissue or lesions can be difficult in small biopsies, ectopic locations, supranumerary glands, and in some oxyphil/oncocytic lesions. Widely available immunohistochemical studies such as chromogranin-A, synaptophysin, keratin, parathyroid hormone, thyroglobulin, and thyroid transcription factor-1 can help in difficult cases. One of the most difficult diagnostic aspects faced by the pathologist in evaluating parathyroid is distinguishing between parathyroid adenoma, particularly atypical adenoma, and parathyroid carcinoma. Many markers have and continue to be evaluated for diagnostic utility, and are even beginning to be studied for prognostic utility. Single immunohistochemical markers such as parafibromin and Ki-67 are among the most studied and most utilized, but many additional markers have and continue to be evaluated such as galectin-3, PGP9.5, Rb, bcl2, p27, hTERT, mdm2, and APC. Although not widely available in many laboratories, a panel of immunohistochemical markers may prove most useful as an adjunct in the evaluation of challenging parathyroid tumors.

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  1. Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Lori A. Erickson

  2. Department of Pathology, Laboratory Medicine Program, University Health System, Toronto, Canada

    Ozgur Mete

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  1. Lori A. Erickson
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  2. Ozgur Mete
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Correspondence to Lori A. Erickson.

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Erickson, L.A., Mete, O. Immunohistochemistry in Diagnostic Parathyroid Pathology. Endocr Pathol 29, 113–129 (2018). https://doi.org/10.1007/s12022-018-9527-6

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