Overview of the 2022 WHO Classification of Parathyroid Tumors

AbstractThe 2022 WHO classification reflects increases in the knowledge of the underlying pathogenesis of parathyroid disease. In addition to the classic characteristic features of parathyroid neoplasms, subtleties in histologic features which may indicate an underlying genetic abnormality reflect increased understanding of the clinical manifestations, histologic, and genetic correlation in parathyroid disease. The importance of underlying genetic aberrancies is emphasized due to their significance to the care of the patient. Traditionally, the term “parathyroid hyperplasia” has been applied to multiglandular parathyroid disease; however, the concept of hyperplasia is generally no longer supported in the context of primary hyperparathyroidism since affected glands are usually composed of multiple “clonal” neoplastic proliferations. In l ight of these findings and management implications for patient care, the 2022 WHO classification endorses primary hyperparathyroidism-related multiglandular parathyroid disease (multiglandular multiple parathyroid adenomas) as a germline susceptibility-driven multiglandular parathyroid neoplasia. Fr om such a perspective, pathologists can provide additional value to genetic triaging by recognizing morphological and immunohistochemical harbingers ofMEN1,CDKN1B,MAX, andCDC73-related manifestations. In the current WHO classification, the term “parathyroid hyperplasia” is now used primarily in the setting of secondary hyperplasia which...

Source: Endocrine Pathology - February 17, 2022 Category: Pathology Source Type: research