PEROPERATIVE FAT STAINING OF FROZEN-SECTIONS IN PRIMARY HYPER-PARATHYROIDISM

Abstract

A fat staining method for rapid peroperative differentiation between parathyroid adenoma and chief cell hyperplasia was recently described. Sudan IV was used in a solution of ethanol and acetone. This solution caused a considerable dissolution of small lipid droplets from the tissues and sections stained with this technique were difficult to interpret. To diminish the loss of fat from the tissue, a modification of Lillie''s supersaturated isopropanol method was used with oil red O. This method gave a deeper staining and increased the difference between hyperfunctioning and uninvolved parathyroid tissue regarding the amount of stainable lipid in the chief cells. It had a valuable supplement, adding a functional dimension to the structural interpretation of the tissue and it facilitated the peroperative distinction between adenoma and hyperplasia. The pattern of lipid distribution within the glands from patients with nodular hyperplasia suggests that the compact nodules are autonomously hyperfunctioning, whereas the intervening parts of the parenchyma are more or less responsive to the serum Ca level.