Polymorphism of parathyroid glands in patients with chronic renal failure and secondary hyperparathyroidism.

The excised parathyroid glands of twenty-one patients with secondary hyperparathyroidism due to chronic renal failure were submitted to careful histopathologic examinations including electron-microscopy. The previous history of these patients who had been on hemodialysis treatment for a certain period was relatively uniform with no association with primary hyperparathyroidism. Although eleven patients had four evenly enlarged parathyroid glands, eight patients showed four unevenly enlarged parathyroid glands with one or two glands weighing less than 100 mg. Histopathologic patterns of hyperplasia are easily divided into two distinctly different patterns, diffuse and nodular. Thirteen cases showed the same histopathological patterns of hyperplasia, either diffuse or nodular, in all excised glands. However, one or two out of four glands in eight patients evidenced a different histopathological pattern.