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Sex-Related C Cell Hyperplasia in the Normal Human Thyroid: A Quantitative Autopsy Study

Laboratoire d’Anatomie Pathologique (S.G., M.-C.R., J.-P.S.-A.) and LHEA-Laboratoire d’Histologie-Embryologie (D.C.), Centre Hospitalier Universitaire, Angers; Laboratoire d’Anatomie Pathologique, Hôpital Raymond Poincaré (M.D.), Garches; Laboratoire d’Anatomie Pathologique, Hôpital Ambroise Paré (B.F.), Boulogne; and Centre Paul Papin, Centre Régional de Lutte contre le Cancer (O.G.), Angers, France

Address all correspondence and requests for reprints to: Prof. Jean-Paul Saint-André, Laboratoire d’Anatomie Pathologique, Centre Hospitalier Universitaire, 49033 Angers Cedex 01, France.

We report a prospective quantitative image analysis study of C cells in 57 normal autopsy thyroid glands, serially sectioned and wholly embedded in paraffin; all slides were immunohistochemically stained for calcitonin. Computerized quantitative image analysis was performed on 47 cases to measure C cell surface area and parenchymatous surface area after immunoperoxidase staining for calcitonin. The method was time-effective, with a good reproducibility. C cells were mainly found in the middle third of each lobe. Important interindividual variations were observed; the maximum C cell surface area in a section (A^max) ranged from 28 x 10³ to 470 x 10³ µm² (mean, 167 x 10³ µm²) among 42 adults. Of particular interest was the important difference observed between sexes; A^max was twice as high in men (mean, 201 x 10³ µm²) as in women (mean, 91 x 10³ µm²; P = 0.0009). Moreover, 14 (33%) adult subjects [2 women (15%) and 12 men (41%)] fulfilled C cell hyperplasia criteria, i.e. at least 3 fields at x100 magnification containing more than 50 C cells, suggesting that a substantial part of the normal adult population could have C cell hyperplasia.

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