They may be pure or mixed cell in type, mostly of chief cells. A thin rim of normal tissue helps differentiate this lesion from hyperplasia. Water-clear cell adenomas may be seen. Patterns can vary depending on vascularity. The remaining glands are usually atrophic with cells containing intracellular fat.
Some cells exhibit concentric laminated smooth faced cisternae.
Nuclei may be hyperchromatic and atypical. Adenoma Gross Image Fig. However almost invariably these tumors are accompanied by hyperparathyroidism, and the symptoms are more severe than in adenomas. Difficult to diagnose, because benign tumors can be pleomorphic. Microscopic Image of Parathyroid Carcinoma Fig.