Characterisation of Kürsteiner canals of parathyroid: imparting relevance to a one-and-a-quarter-century-old concept.

IF 3.9 2区 医学 Q2 CELL BIOLOGY Histopathology Pub Date : 2024-09-24 DOI:10.1111/his.15326
Haley Corbin, Linwah Yip, Sally E Carty, Miguel Reyes-Múgica, Raja R Seethala
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Abstract

Aims: Kürsteiner canals (KC) were described at least 125 years ago as pharyngeal pouch embryological remnants of parathyroid and thymic development. While considered precursors for a subset of parathyroid cysts and salivary heterotopias (SH), they remain enigmatic. We now define a comprehensive phenotype of KC remnants and investigate their role in a spectrum of parathyroid lesions.

Methods and results: `Sixty-two cystic and 22 non-cystic parathyroid lesions (73 patients) were retrieved from our institutional archive (2011-23) and evaluated for the presence of KC and prevalence of KC phenotype in parathyroid hormone (PTH)-positive and PTH-negative cysts. KC phenotype was defined as: cysts and tubules with surrounding sclerosis; bland, unilayered lining with frequent nuclear indentation of lumina; vesicular chromatin relative to chief cells; attenuated eosinophilic to 'hyper-cleared' cytoplasm; and staining pattern PTH-negative, SOX-10-positive, CK7-positive, GATA-3-positive and PAX-9 dim, a subset with oestrogen/progesterone receptor (ER/PR) positivity. Thirty PTH-negative cysts were identified in the neck/mediastinum; 14 of this group also showed SH. Thirty-two PTH-positive cysts included: 11 cystic parathyroid adenomas, 17 hyperplastic parathyroids, and four carcinomas. KC showed two distinct subtypes and were often found near PTH-negative cysts. PTH-negative cysts were associated with inferior parathyroids, SOX-10 positivity, fibrosclerosis, vesicular nuclei indenting cyst lumina and hyper-cleared or attenuated eosinophilic cytoplasm.

Conclusions: KC are common in parathyroids and show a distinct histological and immunohistochemical profile, with an inferior predilection favouring branchial cleft III distribution. Diagnostically, the high prevalence of this phenotype in PTH-negative cysts and salivary heterotopia supports derivation of non-functioning cysts from KC. Conversely, PTH-positive cysts are more compatible with cystic change within hyperfunctioning glands.

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甲状旁腺Kürsteiner管的特征:赋予一个已有四分之一世纪历史的概念以现实意义。
目的:Kürsteiner 管道(KC)至少在 125 年前被描述为甲状旁腺和胸腺发育过程中的咽囊胚胎残留物。虽然KC被认为是甲状旁腺囊肿和唾液异位症(SH)的前体,但它们仍然是谜。我们现在定义了KC残基的综合表型,并研究了它们在甲状旁腺病变中的作用:我们从本机构的档案(2011-23年)中检索了62例囊性和22例非囊性甲状旁腺病变(73例患者),并评估了甲状旁腺激素(PTH)阳性囊肿和PTH阴性囊肿中是否存在KC以及KC表型的流行率。KC表型定义为囊肿和小管周围硬化;内膜平滑、单层,管腔核经常凹陷;相对于主任细胞,染色质呈水泡状;胞质嗜酸性减弱至 "过度清亮";染色模式为PTH阴性、SOX-10阳性、CK7阳性、GATA-3阳性和PAX-9暗淡,其中一个亚群雌激素/孕激素受体(ER/PR)阳性。在颈部/纵膈发现了 30 个 PTH 阴性囊肿,其中 14 个也显示为 SH。32个PTH阳性囊肿包括11个囊性甲状旁腺腺瘤、17个增生性甲状旁腺和4个癌。KC有两种不同的亚型,通常出现在PTH阴性囊肿附近。PTH阴性囊肿与下位甲状旁腺、SOX-10阳性、纤维硬化、囊腔内凹陷的泡状核以及过度清亮或减弱的嗜酸性细胞质有关:结论:KC 常见于甲状旁腺,并表现出独特的组织学和免疫组化特征,偏向于下位,呈支裂 III 型分布。在诊断上,这种表型在PTH阴性囊肿和唾液异位症中的高发率支持从KC衍生出无功能囊肿。相反,PTH 阳性的囊肿更符合功能亢进腺体内囊变的情况。
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来源期刊
Histopathology
Histopathology 医学-病理学
CiteScore
10.20
自引率
4.70%
发文量
239
审稿时长
1 months
期刊介绍: Histopathology is an international journal intended to be of practical value to surgical and diagnostic histopathologists, and to investigators of human disease who employ histopathological methods. Our primary purpose is to publish advances in pathology, in particular those applicable to clinical practice and contributing to the better understanding of human disease.
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