Clonality analysis of benign parathyroid lesions by human androgen receptor (HUMARA) gene assay |
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Authors: | Xavier Sanjuan MD Bonita R Bryant BS Mark E Sobel MD Maria J Merino MD |
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Institution: | (1) Laboratory of Pathology, Bldg 10-Room 2N212, National Cancer Institute, NIH, 9000 Rockville Pike, 20892 Bernesda, MD |
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Abstract: | Benign conditions of the parathyroid gland have been classified as adenomas and hyperplasias. These entities however are difficult
to distinguish when only a single gland is enlarged. Adenomas are defined as neoplastic clonal growths whereas hyperplasias
are considered to be reactive processes of polyclonal origin. In order to analyze the clonal pattern of these lesions, we
have studied hyperplasias and adenomas of parathyroid glands from women by the human androgen receptor (HUMARA) assay, a recently
reliable and highly-informative technique based on the X-chromosome inactivation pattern in females. Samples consisted of
formalin-fixed as well as frozen tissues. Informativeness with HUMARA marker was 87% (13/15 cases). All hyperplasias (5/5)
and 6/8 adenomas yielded polyclonal results, since two alleles of similar intensity appeared when the lesion wasHpaII-digested. Two parathyroid adenomas had a loss of one X-allele for the HUMARA gene and they were interpreted as monoclonal.
These results show that parathyroid hyperplasias and adenomas, considered as multigland or monogland involvement diseases
respectively, may be both polyclonal in origin, and that only a small subset of adenomas is found to be clonal. Consequently,
clonality analysis cannot allow a clear distinction between these two entities as classically diagnosed. A different approach
should be considering hyperplasia or adenoma when a polyclonal or monoclonal result has been obtained by clonality analysis.
Presented in part at the 1998 Annual Endocrine Society Companion Meeting of the United States and Canadian Academy of Pathology.
Boston. MA Feb. 28, 1998. |
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Keywords: | Parathyroid hyperplasia parathyroid adenoma clonality HUMARA assay X-chromosome inactivation microdissection |
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