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Parathyroid Anatomy, Embryology and Histology

  • Nigora Rasulova
  • Qaisar Hussain Siraj
Chapter

Abstract

The parathyroid glands are responsible for calcium homeostasis through secretion of the parathyroid hormone. These glands were the last organ to be recognised in humans. There are normally two pairs of parathyroid glands, superior and inferior, located on the posterior surface of the thyroid gland. The superior parathyroid glands develop from the fourth pharyngeal pouch and are generally located on the posteromedial aspect of the middle one-third of the thyroid, whereas the inferior parathyroids, which develop from the third pharyngeal pouch, are more widely distributed in the region below the inferior thyroid artery. The parathyroid glands may be ectopically located and can be found in variable locations along their migratory pathway. The parathyroid gland parenchyma is mostly composed of chief cells responsible for parathyroid hormone secretion and a smaller number of oxyphil and other cells.

Keywords

Parathyroid glands Osteitis fibrosa cystica Thyroid gland Thymus gland Chief cells Oxyphil cells Endoderm Ectopic parathyroid glands Recurrent laryngeal nerve Hyperparathyroidism Parathyroid diseases Parathyroid hormone Chronic renal insufficiency Secretory vesicles 

References

  1. 1.
    Owen R. On the anatomy of the Indian Rhinoceros (Rh. Unicornis, L). Trans Zool Soc Lond. 1862;4:31.Google Scholar
  2. 2.
    Sandström I. On a new gland in man and several mammals (glandulae parathyroideae). Ups Läk Förh. 1880;15:441.Google Scholar
  3. 3.
    Ellis H. Bailey and Bishop’s notable names in medicine and surgery. London: HK Lewis; 1983. p. 196–8.Google Scholar
  4. 4.
    Carney A. The glandulae parathyroideae of Ivar Sandstrom. Am J Surg Pathol. 1996;20:1123–44.CrossRefGoogle Scholar
  5. 5.
    Mandl F. Therapeutischer versuch bei einem falle von ostitis fibrosa generalisata mittels exstirpation eines epithelkorperchen tumors. Zentrabl Chir. 1926;5:260.Google Scholar
  6. 6.
    Mandl F. Hyperparathyroidism. A review of historical developments and the present state of knowledge on the subject. Rec Adv Surg. 1947;21:374–439.Google Scholar
  7. 7.
    Albright F, Aub JC, Bauer W. Hyperparathyroidism: a common and polymorphic condition as illustrated by seventeen proved cases from one clinic. JAMA. 1934;102:1276–87.CrossRefGoogle Scholar
  8. 8.
    Kunstman JW, Kirsch JD, Mahajan A, Udelsman R. Clinical review: parathyroid localization and implications for clinical management. J Clin Endocrinol Metab. 2013;98:902–12.CrossRefGoogle Scholar
  9. 9.
    Akerstrom G, Grimelius L, Johansson H, Lundquist H, Pertoft H, Bergstrom R. The parenchymal cell mass in normal human parathyroid glands. Acta Pathol Microbiol Immunol Scand A. 1981;89(A):367.Google Scholar
  10. 10.
    Castleman B, Roth SI. Tumors of the parathyroid glands. 2nd series, Fascicle 14. Atlas of Tumor Pathology. Washington, DC: Armed Forces Institute of Pathology; 1978. p. 74–82.Google Scholar
  11. 11.
    Wang C. The anatomic basis of parathyroid surgery. Ann Surg. 1976;183:271–5.CrossRefGoogle Scholar
  12. 12.
    Akerstrom G, Pertoft H, Grimelius L, Johansson H. Density determinations of human parathyroid glands by density gradients. Acta Pathol Microbiol Scand. 1979;87A:91–6.Google Scholar
  13. 13.
    Yao K, Singer FR, Roth SI, Sassoon A, Ye C, Giuliano AE. Weight of normal parathyroid glands in patients with parathyroid adenomas. J Clin Endocrinol Metab. 2004;89:3208–13.CrossRefGoogle Scholar
  14. 14.
    Lappas D, Noussios G, Anagnostis P, Adamidou F, Chatzigeorgiou A, Shandalakis P. Location, number and morphology of parathyroid glands: results from a large anatomical series. Anat Sci Int. 2012;87:160–4.CrossRefGoogle Scholar
  15. 15.
    Ziessman HA, O’Malley JP, Thrall JH, Fahey FH. Nuclear medicine: the requisites. 4th ed. Philadelphia, PA: Elsevier; 2014. p. 66–97.Google Scholar
  16. 16.
    Åkerström G, Malmaeus J, Bergström R. Surgical anatomy of human parathyroid glands. Surgery. 1984;95:14–21.PubMedGoogle Scholar
  17. 17.
    Shaha AR, Jaffe BM. Parathyroid preservation during thyroid surgery. Am J Otolaryngol. 1998;19(2):113–7.CrossRefGoogle Scholar
  18. 18.
    Bliss RD, Gauger PC, Delbridge LW. Surgeon’s approach to the thyroid gland: surgical anatomy and the importance of technique. World J Surg. 2000;24:891–7.CrossRefGoogle Scholar
  19. 19.
    Hunt PS. A reappraisal of the surgical anatomy of the thyroid and parathyroid glands. Br J Surg. 1968;55:63–6.CrossRefGoogle Scholar
  20. 20.
    Moore AA, Roy WA. Rapid review gross and developmental anatomy. 3rd ed. Philadelphia, PA: Mosby Elsevier; 2010.Google Scholar
  21. 21.
    Thompson NW. The techniques of initial parathyroid exploration and reoperative parathyroidectomy. In: Thompson NW, Vinik AI, editors. Endocrine surgery update. New York, NY: Grune and Stratton; 1983. p. 365–83.Google Scholar
  22. 22.
    Nilsson M, Fagman H. Mechanisms of thyroid development and dysgenesis: an analysis based on developmental stages and concurrent embryonic anatomy. Curr Top Dev Biol. 2013;106:123–70.CrossRefGoogle Scholar
  23. 23.
    Kettle AG, O’Doherty MJ. Parathyroid imaging: how good is it and how should it be done? Semin Nucl Med. 2006;36:206–11.CrossRefGoogle Scholar
  24. 24.
    Thompson NW, Eckhauser FE, Harness JK. The anatomy of primary hyperparathyroidism. Surgery. 1982;92(5):814–21.PubMedGoogle Scholar
  25. 25.
    Edis AJ, Purnell DC, van Heerden JA. The undescended‘ parathymus: an occasional cause of failed neck exploration for hyperparathyroidism. Ann Surg. 1979;190:64–8.CrossRefGoogle Scholar
  26. 26.
    Fraker DL, Doppman JL, Shawker TH, et al. Undescended parathyroid adenoma: an important etiology for failed operations for primary hyperparathyroidism. World J Surg. 1990;14:342–8.CrossRefGoogle Scholar
  27. 27.
    Wheeler MH, Williams ED, Wade JSH. The hyperfunctioning intrathyroidal parathyroid gland: a potential pitfall in parathyroid surgery. World J Surg. 1987;11:110–4.CrossRefGoogle Scholar
  28. 28.
    Wheeler MH. Clinical anatomy, developmental aberrations and endocrinology. In: Arora A, Tolley N, Tuttle M, editors. A practical manual of thyroid and parathyroid disease. London: Wiley-Blackwell; 2010. p. 184–5.Google Scholar
  29. 29.
    Dufour DR, Wilkerson SY. The normal parathyroid revisited: percentage of stromal fat. Hum Pathol. 1982;13:717–21.CrossRefGoogle Scholar
  30. 30.
    Emura S, Shoumura S, Utsumi M, Yamahira T, Chen H, Arakawa M, et al. Origin of the water-clear cell in the parathyroid gland of the golden hamster. Acta Anat. 1991;140:357–61.CrossRefGoogle Scholar
  31. 31.
    Lynn J, Lewis P. Pathological spectrum of parathyroid disease. In: Arora A, Tolley N, Tuttle M, editors. A practical manual of thyroid and parathyroid disease. London: Wiley-Blackwell; 2010. p. 175–80.CrossRefGoogle Scholar
  32. 32.
    Chen H, Senda T, Emura S, Kubo K. An update on the structure of the parathyroid gland. Open Anat J. 2013;5:1–9.  https://doi.org/10.2174/1877609401305010001.CrossRefGoogle Scholar
  33. 33.
    Bilezikian JP, Marcus R, Levine MA, Marcocci C, Silverberg SJ, Potts JT, Bilezikian JP. Basic and clinical concepts. London: Elsevier; 2014.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Nigora Rasulova
    • 1
  • Qaisar Hussain Siraj
    • 1
  1. 1.Department of Nuclear MedicineFarwaniya HospitalKuwaitKuwait

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