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Advances in Anatomic Pathology Nov 2022Adrenal gland lesions are present in 1% to 5% of patients and are most commonly identified incidentally on abdominal imaging. Fine needle aspiration (FNA) cytology plays... (Review)
Review
Adrenal gland lesions are present in 1% to 5% of patients and are most commonly identified incidentally on abdominal imaging. Fine needle aspiration (FNA) cytology plays an important role in the initial workup of adrenal gland nodules, especially in patients with a known history of malignancy. The most common reason for adrenal gland FNA is to differentiate benign adrenal lesions, such as adrenal cortical adenoma, from metastatic malignancy. However, there is a significant cytomorphologic overlap between primary and metastatic adrenal neoplasms. This review focuses on the current state of adrenal gland FNA cytology, with an emphasis on distinguishing adrenocortical adenoma from carcinoma and adrenal cortical neoplasms from metastatic malignancies. The role of immunohistochemistry in specifically diagnosing adrenal neoplasms is discussed. Proposed diagnostic classification systems for adrenal gland FNA cytology are also described.
Topics: Humans; Biopsy, Fine-Needle; Adrenal Glands; Adrenal Gland Neoplasms; Immunohistochemistry; Carcinoma
PubMed: 35878423
DOI: 10.1097/PAP.0000000000000356 -
International Journal of Molecular... May 2023The homeostasis of the adrenal gland plays a decisive role in its proper functioning, both in non-stressful conditions and under the influence of various types of...
The homeostasis of the adrenal gland plays a decisive role in its proper functioning, both in non-stressful conditions and under the influence of various types of stress. This consists of interactions between all types of cells that make up the organ, including parenchymal and interstitial cells. The amount of available information on this subject in the rat adrenal glands under non-stressful conditions is insufficient; the aim of the research was to determine the expression of marker genes for rat adrenal cells depending on their location. The material for the study consisted of adrenal glands taken from intact adult male rats that were separated into appropriate zones. Transcriptome analysis by means of Affymetrix Rat Gene 2.1 ST Array was used in the study, followed by real-time PCR validation. Expression analysis of interstitial cell marker genes revealed both the amount of expression of these genes and the zone in which they were expressed. The expression of marker genes for fibroblasts was particularly high in the cells of the ZG zone, while the highest expression of specific macrophage genes was observed in the adrenal medulla. The results of this study, especially with regard to interstitial cells, provide a so far undescribed model of marker gene expression of various cells, both in the cortex and medulla of the sexually mature rat adrenal gland. The interdependence between parenchymal and interstitial cells creates a specific microenvironment that is highly heterogeneous within the gland with respect to some of the interstitial cells. This phenomenon most likely depends on the interaction with the differentiated parenchymal cells of the cortex, as well as the medulla of the gland.
Topics: Rats; Male; Animals; Transcriptome; Adrenal Glands; Adrenal Medulla; Gene Expression Profiling
PubMed: 37298112
DOI: 10.3390/ijms24119159 -
General and Comparative Endocrinology Oct 2020The adrenal gland is an essential component of the body stress response; it is formed by two portions: a steroidogenic and a chromaffin tissue. Despite the anatomy of... (Comparative Study)
Comparative Study Review
The adrenal gland is an essential component of the body stress response; it is formed by two portions: a steroidogenic and a chromaffin tissue. Despite the anatomy of adrenal gland is different among classes of vertebrates, the hormones produced are almost the same. During stress, these hormones contribute to body homeostasis and maintenance of ion balance. The adrenal gland is very sensitive to toxic compounds, many of which behave like endocrine-disruptor chemicals (EDCs). They contribute to alter the endocrine system in wildlife and humans and are considered as possible responsible of the decline of several vertebrate ectotherms. Considering that EDCs regularly can be found in all environmental matrices, the aim of this review is to collect information about the impact of these chemical compounds on the adrenal gland of fishes, amphibians and reptiles. In particular, this review shows the different behavior of these "sentinel species" when they are exposed to stress condition. The data supplied in this review can help to further elucidate the role of EDCs and their harmful impact on the survival of these vertebrates.
Topics: Adrenal Glands; Amphibians; Animals; Chromaffin Cells; Endocrine Disruptors; Fishes; Reptiles
PubMed: 32679158
DOI: 10.1016/j.ygcen.2020.113550 -
Endocrinologia, Diabetes Y Nutricion Apr 2023Primary bilateral macronodular adrenal hyperplasia (PBMAH) accounts for <2% of cases of Cushing's syndrome. The majority of patients present with no obvious steroid... (Review)
Review
Primary bilateral macronodular adrenal hyperplasia (PBMAH) accounts for <2% of cases of Cushing's syndrome. The majority of patients present with no obvious steroid excess it means with autonomous cortisol secretion (ACS). The classic treatment for patients with overt Cushing's syndrome is bilateral adrenalectomy, but unilateral resection of the larger adrenal gland can result in clinical and/or biochemical remission in >90% of cases, especially in cases of ACS. In this article, a series of 32 cases with PBMAH is described. Most of the cases of PBMAH had ACS, except for one case with overt Cushing's syndrome. A study of aberrant receptors was performed in six patients, being negative in three cases, positive in the metoclopramide test in two cases and positive in the metoclopramide test and in the mixed meal test in another patient. The patient with overt Cushing's syndrome was treated with adrenostatic therapy achieving biochemical control, while two patients with ACS underwent unilateral adrenalectomy with resection of the largest adrenal gland, demonstrating hypercortisolism remission and improvement of cardiovascular risk factors after surgery. This article describes a series of 32 cases of PBMAH and offers a comprehensive review of PBMAH.
Topics: Humans; Cushing Syndrome; Hyperplasia; Metoclopramide; Hydrocortisone; Adrenal Glands
PubMed: 37116968
DOI: 10.1016/j.endien.2023.04.005 -
Anatomia, Histologia, Embryologia Nov 2022The canine adrenal glands receive blood from the celiac artery, cranial mesenteric artery, caudal phrenic artery, cranial abdominal artery, phrenicoabdominal trunk,...
The canine adrenal glands receive blood from the celiac artery, cranial mesenteric artery, caudal phrenic artery, cranial abdominal artery, phrenicoabdominal trunk, abdominal aorta, renal artery and lumbar artery. These are classified into three types: cranial, middle and caudal adrenal branches. It is also known that the adrenal vein flows into the phrenicoabdominal vein. However, individual differences in the branching pattern of adrenal vessels have not been systematically analysed. We evaluated adrenal vessels in dogs that underwent contrast-enhanced abdominal computed tomography (CT). There were 255 arteries travelling to the adrenal glands in 47 cases, with 1-6 arteries travelling per adrenal gland. The arteries included 67 caudal phrenic arteries, 62 aortic arteries, 60 cranial abdominal arteries, 39 renal arteries, 12 phrenicoabdominal trunks, 8 cranial mesenteric arteries, 6 celiac arteries and 1 lumbar artery. Most of the branches were from the aorta and caudal phrenic artery on the left side, and the cranial abdominal and caudal phrenic artery on the right side. A total of 110 adrenal veins were identified. Inflow into the phrenicoabdominal vein and into the right and left renal veins was observed, and we identified no inflow into other veins. This study demonstrated two points: laterality and individual differences in adrenal blood vessels. When evaluating adrenal blood vessels with abdominal contrast-enhanced CT, it is recommended to take images under general anaesthesia with breath-holding and observe them using multiplanar reconstruction.
Topics: Dogs; Animals; Renal Artery; Abdomen; Aorta, Abdominal; Renal Veins; Adrenal Glands
PubMed: 36047693
DOI: 10.1111/ahe.12858 -
Nature Aging Jul 2023
Topics: Female; Humans; Male; Adrenal Gland Neoplasms; Adrenal Glands; Aging; Sex Factors
PubMed: 37291221
DOI: 10.1038/s43587-023-00440-y -
The British Journal of Radiology Nov 2021Adrenal hemorrhage (AH) is a rare condition. It can be traumatic or non-traumatic. Most common causes are septicemia, coagulopathy or bleeding diathesis, and underlying... (Review)
Review
Adrenal hemorrhage (AH) is a rare condition. It can be traumatic or non-traumatic. Most common causes are septicemia, coagulopathy or bleeding diathesis, and underlying neoplasms. Other reported less common causes of AH are COVID-19 and neonatal stress. Clinical diagnosis of AH is challenging due to its non-specific presentation and occurrence in the setting of acute medical illness. Therefore, most cases are diagnosed incidentally on imaging. Having high clinical suspicion in the proper clinical setting for AH is crucial to avoid life-threatening adrenal insufficiency that occurs in 16-50% of patients with bilateral AH. We discuss the clinical situations that predispose to AH, review the imaging features on different imaging modalities, highlight a variety of clinical cases, imaging features that should be concerning for an underlying neoplasm, and outline the potential role of interventional radiology in management of AH.
Topics: Adrenal Gland Diseases; Adrenal Glands; Diagnostic Imaging; Hemorrhage; Humans
PubMed: 34464549
DOI: 10.1259/bjr.20210753 -
Journal of Feline Medicine and Surgery Apr 2020The objectives of this study were to describe the CT characteristics of the adrenal glands in healthy cats, to provide normal reference biometry for adrenal gland size...
OBJECTIVES
The objectives of this study were to describe the CT characteristics of the adrenal glands in healthy cats, to provide normal reference biometry for adrenal gland size and attenuation values, and to investigate the association with age, sex, laterality and body weight.
METHODS
Retrospective evaluation of 30 CT studies of healthy adult cats recruited from September 2013 to July 2015 was performed. Healthy cats >1 year of age were included based on the absence of clinical signs, unremarkable physical examination, normal results of the complete blood count, biochemical profile, feline immunodeficiency virus, feline leukaemia virus and species infection tests. The relationship between gland biometry (size and attenuation values) and the age, sex, laterality and body weight of cats were tested by two-way ANOVA. The intraclass correlation coefficient was assessed and mean, SD, range provided.
RESULTS
Twenty-seven cats were included. Bilobed, arrowhead and oval adrenal gland shape patterns were recognised, the first being most common. No statistically significant differences were observed between the biometric parameters (length, height and attenuation values) and age, sex, Regarding the width of the adrenal glands, there was a statistically significant effect of sex and laterality. he length (11.6 ± 2.1 mm) and height (6.1 ± 1.3 mm) were the most consistent biometrical parameters to describe adrenal glands.
CONCLUSIONS AND RELEVANCE
Adrenal gland shape, size and attenuation CT data of healthy feline patients are provided in this study, as well as normal reference intervals for morphometric characterisation based on adrenal length and height.
Topics: Adrenal Glands; Animals; Body Weight; Cats; Female; Male; Reference Values; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 30942657
DOI: 10.1177/1098612X19840090 -
Epicardial adipose tissue and adrenal gland volume in patients with borderline personality disorder.Journal of Psychiatric Research Dec 2021Borderline personality disorder (BPD) is associated with an elevated mortality risk that is partially attributed to suicide, but few studies examined other possible...
Borderline personality disorder (BPD) is associated with an elevated mortality risk that is partially attributed to suicide, but few studies examined other possible causes of premature death. The present study compared epicardial adipose tissue (EAT) volume as a known early predictor of premature cardiovascular morbidity, cardiovascular risk indices, and adrenal gland volume (AGV) as an indicator for chronic hypothalamus-pituitary-adrenal (HPA) axis activation in females with borderline personality disorder (BPD), major depressive disorder (MDD) and in healthy individuals. Twenty-eight patients with BPD comorbid with MDD (BPD/MDD), 22 MDD patients and 26 healthy females (CTRL) of comparable age were included. EAT and AGV were assessed by magnetic resonance tomography; 10-year cardiovascular risk and diabetes risk were determined by PROCAM and FINDRISK score; metabolic syndrome was defined following National Cholesterol Education Adult Treatment Panel III R (NCEP/ATP III) criteria. MADRS was used to assess depression severity. After adjustment for age, body mass index (BMI), and physical activity, EAT and AGV were significantly increased in BPD/MDD compared to MDD and CTRL. EAT and AGV displayed a positive correlation. Finally, diabetes risk in BPD/MDD was elevated compared to CTRL and MDD. The present study highlights the increased cardiometabolic risk of BPD patients. We identify EAT accumulation as an early predictor and potential mediator of cardiovascular disease in BPD that appears to be driven at least in part by HPA axis dysregulation. Therefore, interventions that reduce EAT volume (i.e. exercise and diet) should be considered in the clinical management of BPD.
Topics: Adipose Tissue; Adrenal Glands; Adult; Borderline Personality Disorder; Depressive Disorder, Major; Female; Humans; Hypothalamo-Hypophyseal System; Pituitary-Adrenal System
PubMed: 34715600
DOI: 10.1016/j.jpsychires.2021.10.039 -
Science Advances Jul 2023Corticosteroids regulate vital processes, including stress responses, systemic metabolism, and blood pressure. Here, we show that corticosteroid synthesis is related to...
Corticosteroids regulate vital processes, including stress responses, systemic metabolism, and blood pressure. Here, we show that corticosteroid synthesis is related to the polyunsaturated fatty acid (PUFA) content of mitochondrial phospholipids in adrenocortical cells. Inhibition of the rate-limiting enzyme of PUFA synthesis, fatty acid desaturase 2 (FADS2), leads to perturbations in the mitochondrial lipidome and diminishes steroidogenesis. Consistently, the adrenocortical mitochondria of mice fed a diet with low PUFA concentration are structurally impaired and corticoid levels are decreased. On the contrary, FADS2 expression is elevated in the adrenal cortex of obese mice, and plasma corticosterone is increased, which can be counteracted by dietary supplementation with the FADS2 inhibitor SC-26192 or icosapent ethyl, an eicosapentaenoic acid ethyl ester. In humans, expression is elevated in aldosterone-producing adenomas compared to non-active adenomas or nontumorous adrenocortical tissue and correlates with expression of steroidogenic genes. Our data demonstrate that FADS2-mediated PUFA synthesis determines adrenocortical steroidogenesis in health and disease.
Topics: Humans; Mice; Animals; Fatty Acid Desaturases; Lipidomics; Fatty Acids, Unsaturated; Adrenal Glands; Adenoma
PubMed: 37478183
DOI: 10.1126/sciadv.adf6710