Results of diagnostic needle bone biopsies in 25 patients subsequently undergoing neck exploration for parathyroid disease are reported. Histologic changes believed to represent hyperparathyroidism in bone biopsy specimens included evidence of (1) increased osteoblastic activity; (2) increased osteoid formation; and (3) excessive osteoclastic activity. Such changes were seen in 23 of 25 biopsies. The results of two biopsies were negative.
A positive correlation between pathologic findings in bone and surgically proven primary hyperparathyroidism was noted in 20 of 25 patients. Nine of the patients with abnormal biopsies had hyperparathyroidism, despite normal roentgenograms and alkaline phosphatase levels. Explanations accounting for abnormal biopsies in three patients with negative results for neck exploration were available. Two patients with proven parathyroid adenoma had negative results for bone biopsies. With proper interpretation, needle bone biopsy is a useful tool for evaluation of primary hyperparathyroidism.