PMC8371401_01
Histological and immunohistochemical attributes of the parathyroid adenoma with respiratory-like epithelium. (A) Hematoxylin-eosin (H&E) stain of the excised lesion depicting a cystic appearance (right), with normal rim of parathyroid tissue to the left. Magnification x20. (B, C) Cells were pseudo-stratified and cylindrical with palisading nuclei and, appearing focally, processes reminiscent of apical cilia, magnification x200 and x400 respectively. (D) Diffuse and strong PTH immunoreactivity was noted.
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Histologically, the lesion demonstrated a multilobar, cord-like cystic growth pattern, with a single-lined, pseudostratified epithelium built-up by cylindrical cells with basal-positioned nuclei and vacuolated cytoplasm (Figure 1). Immunohistochemistry was performed, and the cylindrical cells displayed diffuse positivity for the AE1/AE1 pan-keratin cocktail, PTH, GATA binding protein 3 (GATA3) and polyclonal Paired box 8 (PAX8), thereby verifying them as parathyroid-derived (Figure 1).