Bondeson et al reported histologic features of parathyroid carcinomas. The authors are from Malmo general Hospital, Karolinska Hospital and Uppsala University.
Patient selection: parathyroid carcinoma
Criteria for a diagnosis of definitive carcinoma:
(1) extraglandular invasiveness including metastasis
(2) tumor recurrence
A minority of parathyroid carcinomas show a bland morphology but extraglandular invasiveness. The mitotic rate in these tumors may not exceed that seen in adenomas.
Histologic features seen in more aggressive tumors:
(1) mitotic rate
(2) nuclear atypia
(3) macronnucleoli
Triad of features associated with recurrence:
(1) macronucleoli
(2) mitotic rate > 5 mitoses in 50 high power fields
(3) necrosis
Fibrosis and necrosis can be seen but are neither constant nor pathognomonic for malignancy.
The authors studied DNA cytometry but the study preceded widespread use of proliferative markers. The p90 value was higher in tumors designated carcinomas.
To read more or access our algorithms and calculators, please log in or register.
