Abstract:
Objective To investigate the anatomical characteristics of the parathyroid lymphatic system and the mechanism of the "negative development"of the carbon nanoparticles for parathyroid gland in thyroidectomy.
Methods This retrospective study used parathyroid tissue samples from patients that were obtained from archival records in the pathology department, including 45 cases of normal parathyroid gland tissues that were accidentally resected in thyroidectomy, 10 cases of parathyroid adenomas, and 7 cases of parathyroid carcinoma. Ten cases of normal thyroid tissues were selected as positive control. Immunohistochemistry was performed using the antibodies specific for lymphatic endothelium, such as D2-40 and LYVE-1, and antibodies specific for vascular endothelial cell such as CD31 and CD34, to distinguish them from each other.
Results A total of 62 parathyroid glands samples were stained with vascular markers CD31, CD34 and lymphatic markers D2-40, LYVE-1 respectively (partial samples were stained unsuccessfully). Vascular vessels in the CD31 staining group were detected in 50 of 58 examined glands and the positive rate was 86.2%. In the CD34 staining group, positive rate was 100% (60/60). The positive cells were found in the central, periphery and vascular hilum of the glands. However, lymph vessels in the D2-40 staining group were detected from 17 out of 59 examined glands, with the positive rate of 28.8%; In the LYVE-1 staining group, positive rate was 39.6% (23/58). The positive cells were found in the membrane or vascular hilum, less frequent or undetectable in the central portion.
Conclusions Most of the parathyroid glands of adults might lack a lymphatic network. Only a few adult parathyroid glands had minority lymph vessels, and these lymphatics generally localized at the membrane area or in the vascular hilum, which could be one of the main and anatomical mechanisms resulting in drainage failure or obstruction of carbon nanoparticles and thus in parathyroid "negative development."
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