566 OSKAE KLOTZ 



As is so often observed in other tissues, and organs, the parathyroids 

 may show evidence of nutritional disturbances when serious lesions in- 

 volve other structures. Fatty degeneration may involve the parathyroids 

 without destroying their secretory ability in cirrhosis of the liver, chronic 

 nephritis, chronic tuberculosis, diabetes and pyelonephrosis (Thompson 

 and Harris). These authors have found that the parathyroids are apt to 

 show fatty change when an acute infection is superimposed upon a chronic 

 one. This was particularly marked in five cases of ascending infection of 

 the genito-urinary tract. They have also observed the presence of marked 

 fatty change in four cases of infection of the gall bladder and ducts asso- 

 ciated with extreme jaundice. In malignant disease and in syphilis of 

 long standing, fatty change of the parathyroids is encountered in variable 

 quantity. The same is also true in pernicious anemia and the chronic 

 blood diseases. There is no evidence that the parathyroids primarily suf- 

 fer serious degeneration of the fatty type. The condition appears to arise 

 as a process secondary to systemic derangements. Bauer claims to have 

 noted a diminished fat content of the parathyroid tissue in cases of ade- 

 noma of the parathyroid with osteomalacia. 



Colloid Degeneration. Comment has been repeatedly made on the oc- 

 currence of colloid degeneration of the parathyroid. In some instances, 

 the authors have referred \o the presence of small masses of colloid mate- 

 rial lying within the glandular portion, while others have referred to a 

 disturbance of the alveolar arrangement by the presence of small 

 quantities of homogeneous material, and an alteration of the stroma to 

 assume a hyaline appearance. The presence of colloid within the alveoli 

 is not uncommon in individuals above twenty years of age. In the young, 

 as well as in a certain number of individuals in middle life, the complete 

 absence of any colloid is normal. At times the gland tissue shows large 

 numbers of the alveoli with sufficient colloid in their centers to give them 

 the appearance of small acini, with the epithelial cells crowded along the 

 periphery as is seen in thyroid tissue. The presence of this colloid storage 

 has led some to assume that the parathyroid was adopting the qualities of 

 thyroid tissue, and that its change was the result of an unusual demand 

 following functional disturbance of the thyroid. Where extirpation of the 

 thyroid lias been undertaken, and the parathyroids have shown the pres- 

 ence of colloid within their acini, it has 1 been interpreted as indicating a 

 compensatory function. But evidence is still lacking that a parathyroid 

 can participate in the activities of the thyroid. The presence of colloid 

 within the alveoli need not be viewed as a process of degeneration, but one 

 within the normal character of these glands. When, however, the accumu- 

 lation is of undue quantity, and leads to cystic dilatation of the acini, as 

 well as the merging of several neighboring structures with each other, and 

 at times accompanied by hemorrhage, we are then dealing with a patho- 

 logical process. The colloid that makes its appearance under these condi- 



