Clinical examples of amyloid deposition in parathyroid glands are exceedingly rare and usually present as an incidental finding in a patient with amyloid goiter. Here, we present the first histologically documented case of parathyroid amyloid deposition that presented as a mass. The patient did not have hyperparathyroidism. The parathyroid gland was submitted for intra-operative frozen section and concern for medullary thyroid carcinoma was raised. An important histologic clue arguing against medullary thyroid carcinoma was the evenly dispersed nature of the amyloid. Histologic perinuclear clearing and parathyroid hormone immunohistochemistry confirmed parathyroid origin on permanent sections. The patient was also found to have associated amyloid goiter. Mass spectrometry of the amyloid showed it to be composed of kappa light chains. On further work-up, the patient was diagnosed with multiple myeloma. Awareness of parathyroid amyloid deposition is important as it is a histologic mimic of medullary thyroid carcinoma, especially on frozen section. Amyloid typing with evaluation for multiple myeloma in any patient with kappa or lambda light chain restriction is also important.
Background
Human papillomavirus (HPV) has been aetiologically linked with several different cancers. A'few older studies have evaluated the effects of interferon-α (IFN-α) treatment on HPV infection and HPV-related dysplasia. However, findings from these studies may not be generalisable to the more recent formulations of IFN-α used to treat hepatitis C virus (HCV) infection. Methods: The purpose of this small pilot study was to assess whether treatment for HCV, by pegylated rather than standard IFN-α, was associated with presence or distribution of the types of HPV found in the oral, penile, and anal regions of HIV and HCV co-infected men. Participants completed a validated risk factor questionnaire. The prevalence and types of HPV present in the anal, penile, and oral swabs were determined using the Roche HPV Linear Array (Roche Molecular Systems), according to the manufacturer’s instructions. Results: A total of 33 men were enrolled in this pilot study. Of these, 10 were in the IFN-α-exposed group and 23 were in the IFN-α-naïve comparison group. The IFN-α-naïve group had a higher average number of different HPV types present in penile and oral swabs, but not in anal swabs, compared with the treated group. Conclusions: The results of this small pilot study are preliminary. However, our findings have provided some rationale for continuing to explore whether pegylated IFN-α may be a useful adjuvant therapy, or whether it could be combined with other treatment modalities for controlling HPV infection/disease, specifically of the penis or oral mucosa, among high-risk populations.
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