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. 2018 May 18;97(20):e10816. doi: 10.1097/MD.0000000000010816

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Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc.

This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author. http://creativecommons.org/licenses/by-nd/4.0

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Partial excision of autotransplanted parathyroid gland and pathologic analysis. Before the fourth operation, B-ultrasound revealed multiple hypoechoic nodules (A1–2, arrows), and technetium-99m methoxyisobutylisonitrile (^99mTc-MIBI) parathyroid scintigraphy showed increased uptake of soft tissue lesions (B1–2, arrows). Intraoperatively, 4 markedly enlarged autotransplanted parathyroid glands (C1–4, arrows) were resected. Pathologic analysis showed secondary hyperplasia of the parathyroid (D1–4) in striated muscle tissue. Hematoxylin and eosin staining (magnification, ×40 for D1 and D2, ×100 for D3 and D4).