Clinicopathologic features of atypical parathyroid adenoma

LIU Bao-yue; ZUO Qing-yao; SUN Xiao-qi

doi:10.3969/j.issn.1007-8096.2017.07.012

Abstract：Objective To investigate the pathological features of atypical parathyroid adenoma.Methods Thepathological sections and clinical data of 37 patients with APA that were diagnosed in the Department of Pathology,BeiJingJishuitan Hospital,were retrospectively analyzed.Results Among the 37 cases,including 15 males and 22 females,theage ranged from 23-78 years and the average age was 48.3 years.The maximum diameter of tumors was from 0.8 cm to 5cm.8 tumors (22.9％)with an integrated capsule and others with fragmented capsule or adherent to adjacent tissue.29cases(78.4％)presented irregular wide fibrous bands and the bands extended to the capsule of the tumor frequently.32cases(86.5％)showed an capsule invasion but not penetrated the capsule fully.The variable degrees of atypia was observedin 18 cases (48.6％).The pathological mitosis was occasionally found in 7 cases (18.9％),but much less than 5/50HPF.3 cases (8.1％)presented focal necrosis.4 cases(10.8％)encountered recurrence and all of them were diagnosedas malignant later,including 2 capsular invasion,1 vascular invasion and 1 pulmonary metastasis.Conclusion Thehistopathological features of APA are similar to carcinoma but the prognosis is favorable just like the classical adenoma.Thediagnostic criterion should be mastered and the strict follow-up is necessary in order to avoid the misdiagnosis of individualmalignant case.