In the WHO fifth edition 2022 classification of endocrine neoplasia several developments in the field of endocrine neoplasia have been acknowledged. In the parathyroid previous concepts of primary hyperplasia (for example in the setting of MEN1) have been replaced by the concept of multiglandular multiadenomatous disease in recognition that each of the nodules within the adrenals are clonal and therefore neoplastic. In the adrenal, the HISTALDO classification for adrenal pathology associated with Conns syndrome was endorsed and clarified. Similar to the parathyroid, concepts of primary adrenal hyperplasia have largely been replaced by the concept of multiglandular multiadenomatous disease