Oxyphil cells in primary hyperparathyroidism: a clinicopathological study

Abstract

The role of oxyphil cells (OxC) in primary hyperparathyroidism (PHPT) still remains controversial. Historically, they were believed to be involuted cells. However, they could play an important role in hormone secretion. The clinical behavior of OxC-rich adenomas and preoperative PHPT localization tests have been widely studied. The aim of this study is to analyze the implications of OxC in PHTP. A retrospective cohort study of patients undergoing parathyroidectomy for PHPT was conducted. Additionally, we included normal glands removed in the context of PHPT or inadvertently during a thyroidectomy. All glands were reviewed independently by three researchers, performing a semi-quantitative analysis of the percentage of OxC. Groups with\u2009<\u200925% OxC and\u2009>\u200975% OxC were compared. In the period 2010–2017, 238 patients and 261 removed glands were included (8.8% OxCA\u2009>\u200975%). There were no differences in symptomatology and levels of preoperative calcium, parathormone, or 25-OH vitamin. Patients with OxCA\u2009>\u200975% had worse preoperative glomerular filtration rate (81.2 vs. 69.7 mL/min/1.73 m2; p\u2009=\u20090.043). They also had a trend towards larger size and weight (17 vs. 20 mm, p\u2009=\u20090.135 and 562 vs. 875 mg, p\u2009=\u20090.495), while ultrasound was found to have better accuracy (48.3% vs. 73.7%; p\u2009=\u20090.035). There were no normal glands with a content of OxC\u2009>\u200975%. Our study suggests that phosphocalcic metabolism is not influenced by the presence of a high content of OxC in the parathyroid glands. A high content of OxC seems to be exclusive to pathologic glands and could be related to the deterioration of renal function in patients with PHPT.