Demonstration by Immunoperoxidase Staining of Hyperplasia of Parafollicular Cells in the Thyroid Gland in Hyperparathyroidism

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Abstract
Immunoperoxidase staining, using rabbit antihuman calcitonin, was performed on fixed, deparaffinized sections of thyroid tissue from patients with hypercalcemia caused by parathyroid adenomas. In these sections, positively stained cells were identified in a parafollicular location. These cells were ovoid to rectangular, occasionally showing unipolar cytoplasmic extensions. The staining was granular in character and was localized to the cytoplasm. Occasional clusters of these cells were noted. Control sections of normal thyroid glands and of glands from patients with various thyroid disorders were also stained. In these control sections, 50 or fewer stained cells per 50 low power (×100) fields were identified, whereas in comparable sections of thyroid glands from hypercalcemic patients as many as 880 calcitonin-containing cells were counted. Hyperplasia of parafollicular cells was found in 36% of 14 hyperparathyroid patients studied. Neither parathyroid adenomas nor thymic remnants found in some of these patients contained stained cells. Positive staining was abolished by prior absorption of the primary antiserum with synthetic human calcitonin M. Numbers of stained cells did not correlate with the level of serum calcium, or with the size or histological type of the parathyroid adenoma. We conclude that a significant number of patients with primary hyperparathyroidism have concomitant hyperplasia of calcitonin-containing parafollicular cells.

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