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Frontiers in Endocrinology 2022Mixed pituitary TSH/GH adenomas are rare adenomas associated with acromegaly and/or thyrotoxicosis, with or without varying degrees of goiter. In this report, we show a... (Review)
Review
BACKGROUND
Mixed pituitary TSH/GH adenomas are rare adenomas associated with acromegaly and/or thyrotoxicosis, with or without varying degrees of goiter. In this report, we show a case of pituitary adenoma producing both GH and TSH simultaneously.
CASE PRESENTATION
A 27-year-old man was diagnosed with pituitary adenoma based on various symptoms and clinical findings. For further examination and treatment, he was hospitalized in our institution. It was likely that this subject had pituitary adenoma producing both GH and TSH. In brain magnetic resonance imaging, there was a giant tumor in the sellar region. After the diagnosis of mixed pituitary TSH/GH adenoma, he was treated with octreotide, then underwent tumor resection, and then received hydrocortisone acetate and levothyroxine sodium. After then, GH and IGF-1 levels were suppressed and thyroid function was normalized. Postoperative immunohistochemistry reports showed GH (+) but TSH (-), which may be insensitive to the antibody used to detect TSH or combined with other factors.
CONCLUSIONS
The diagnosis of mixed pituitary TSH/GH adenoma must be combined with clinical manifestations, immunohistochemical staining and relevant hormone levels, and genetic testing if necessary for comprehensive judgment. For patients with large adenomas, it is recommended to use somatostatin analogs to restore TH levels and control the excessive secretion of GH levels before surgery.
Topics: Male; Humans; Adult; Pituitary Neoplasms; Acromegaly; Thyrotropin; Adenoma; Hyperthyroidism
PubMed: 36619586
DOI: 10.3389/fendo.2022.1072647 -
Clinical and Translational... Oct 2023Colorectal cancer screening plays a vital role in early detection and removal of precancerous adenomas, contributing to decreased mortality rates. Most polyps found... (Review)
Review
Colorectal cancer screening plays a vital role in early detection and removal of precancerous adenomas, contributing to decreased mortality rates. Most polyps found during colonoscopies are small and unlikely to harbor advanced neoplasia or invasive cancer, leading to the development of "leave-in-situ" and "resect-and-discard" approaches. These strategies could lead to significant cost savings and efficiencies, but their implementation has been hampered by concerns around financial incentives, medical-legal risks, and local rules for tissue handling. This article reviews the potential of artificial intelligence to enhance the accuracy of polyp diagnosis through computer-aided diagnosis (CADx). While the adoption of CADx in optical biopsy has shown mixed results, it has the potential to significantly improve the management of colorectal polyps. Several studies reviewed in this article highlight the varied results of CADx in optical biopsy for colorectal polyps. Although artificial intelligence does not consistently outperform expert endoscopists, it has the potential to serve as a beneficial secondary reader, aiding in accurate optical diagnosis and increasing the confidence of the endoscopist. These studies indicate that although CADx holds great potential, it is yet to fully meet the performance thresholds necessary for clinical implementation.
Topics: Humans; Colonic Polyps; Artificial Intelligence; Colonoscopy; Adenoma; Narrow Band Imaging
PubMed: 37747097
DOI: 10.14309/ctg.0000000000000640 -
Frontiers in Bioscience (Landmark... Mar 2022Pituitary adenomas (PA), or pituitary neuroendocrine tumors (PitNETs), represent 15% of all central nervous system tumors. Classic description of PitNETs solely by... (Review)
Review
Pituitary adenomas (PA), or pituitary neuroendocrine tumors (PitNETs), represent 15% of all central nervous system tumors. Classic description of PitNETs solely by hormonal classification has given way to key transcription factors that play a role in the pathology of PitNETs including steroidogenic factor-1 (SF-1), t-box pituitary transcription factor (TPIT), and pituitary transcription factor 1 (PIT-1). Germline mutations in various familial PitNETs are discussed including those in familial isolated pituitary adenoma (FIPA), multiple endocrine neoplasia (MEN), neurofibromatosis 1 (NF1), and Carney complex. Recent advances in next generation sequencing have improved insight into the pathogenesis of PitNETs. A review of key studies in evaluating the genomic analysis of PitNETs was performed. Chromosomal mutations, whole exome sequencing, microRNA genomics, methylomics and transcriptomics were analyzed. Moreover, the multiomic analysis of various genomic panels has helped to better understand PA classification.
Topics: Adenoma; Growth Hormone-Secreting Pituitary Adenoma; Humans; MicroRNAs; Neuroendocrine Tumors; Pituitary Neoplasms; Transcription Factors
PubMed: 35345309
DOI: 10.31083/j.fbl2703077 -
Frontiers in Endocrinology 2022To investigate the value of mean attenuation value (AV), minimum attenuation value (AV), and CT histogram (CTH) for the differential diagnosis of adrenal adenoma and...
Differential diagnostic value of plain CT scan in adrenal adenoma and non-adenoma: A two-center control study of mean attenuation value, minimum attenuation value, and CT histogram.
OBJECTIVES
To investigate the value of mean attenuation value (AV), minimum attenuation value (AV), and CT histogram (CTH) for the differential diagnosis of adrenal adenoma and non-adenoma in two medical centers.
METHODS
The plain CT data of 403 cases of adrenal adenoma and 141 cases of non-adenoma in center A were retrospectively analyzed, and compared with data of 86 cases of adenoma and 71 cases of non-adenoma in center B. All cases were confirmed by pathology or clinical follow-up. The diagnostic efficacy of AV ≤ 10 Hounsfield units (HU), AV ≤ 0 HU, and CTH negative pixels ≥ 10% for adrenal adenoma, and AV and CTH for adenoma with AV > 10Hu were compared between the two medical centers.
RESULTS
In medical centers A and B, the AUC of AV for the differential diagnosis of adenoma and non-adenoma was 0.956 and 0.956, respectively, and the corresponding sensitivity, specificity, and accuracy were, 0.591 and 0.663, 1.000 and 1.000, 0.697, and 0.815, respectively, when the threshold was ≤ 10 HU. The AUC of AV was 0.941 and 0.958, respectively, and the corresponding sensitivity, specificity, and accuracy were 0.869 and 0.826, 0.986, and 0.972, 0.899, and 0.892, respectively, when the threshold was ≤ 0 HU. The AUC of CTH negative pixels was 0.948 and 0.952, respectively, and the corresponding sensitivity, specificity, and accuracy were 0.759 and 0.674, 1.000 and 1.000, 0.822, and 0.822, respectively, when the threshold was ≥ 10%. Among adenoma with AV >10 HU, the best threshold of AV in center A and center B were -0.250HU and 2.375HU, and the corresponding AUC, sensitivity and specificity were 0.858 and 0.846, 0.691 and 0.586, 0.986 and 0.958; the best threshold of CTH in center A and center B were 0.895% and 0.775%, and the corresponding AUC, sensitivity and specificity were 0.873 and 0.822, 0.818 and 0.724, 0.837 and 0.915.
CONCLUSION
AV, AV, and CTH are all important parameters for differentiating adrenal adenoma from non-adenoma. Even for adenomas with AV > 10 HU, AV and CTH still had high diagnostic efficiency. The three parameters are complementary, assisting clinicians to develop personalized treatments.
Topics: Humans; Adrenal Gland Neoplasms; Retrospective Studies; Adrenocortical Adenoma; Adenoma; Tomography, X-Ray Computed
PubMed: 36440234
DOI: 10.3389/fendo.2022.1007870 -
Frontiers in Endocrinology 2023Complete resection of invasive pituitary adenoma is usually difficult, resulting in a high recurrence rate. Therefore, it is needed to find potential diagnostic markers...
BACKGROUND
Complete resection of invasive pituitary adenoma is usually difficult, resulting in a high recurrence rate. Therefore, it is needed to find potential diagnostic markers and therapeutic targets for invasive pituitary adenoma.
METHODS
We collected samples from patients with invasive and non-invasive pituitary adenomas from Beijing Tiantan Hospital for protein extraction and quantitative analysis. We identified differential proteins (DEPs) by differential analysis of the two groups. The intersection of differential proteins related to invasion and epithelial-mesenchymal transition (EMT) in the GeneCards database was identified as EMT-DEPs. The protein network of EMT-DEPs was analyzed using the STRING database and Cytoscape software, and the hub EMT-DEPs were obtained by the MCC algorithm of the cytoHubba plugin. Correlation analysis was used to obtain the interpairing proteins among EMT-DEPs, and core EMT-DEPs were identified based on the number of paired proteins. The Venn program was used to identify the intersection of hub EMT-DEPs and core EMT-DEPs as key EMT-DEPs. Finally, a series of analyses plus experiments were used to verify the correlation of the target protein with invasion and EMT in pituitary adenoma.
RESULTS
Quantitative comparison of proteins between invasive and non-invasive pituitary adenomas indicated 833 differential proteins. The overlaps of EMT-related proteins and differential proteins consisted of 46 EMT-DEPs. There were 6 intersections between the hub EMT-DEPs and core EMT-DEPs. Using quantitative protein data and GSE169498 chip, we found that solute carrier family 2 member 1 (SLC2A1) was our target protein. SLC2A1 was significantly correlated with the invasiveness of pituitary adenoma, and the ROC curve was satisfactory. The functions and pathways of SLC2A1 and paired protein enrichment were closely linked to the EMT. Consistently, SLC2A1 expression was significantly and positively correlated with the expression of classical markers of EMT. The final experiment revealed that SLC2A1 was significantly upregulated in invasive pituitary adenoma.
CONCLUSION
SLC2A1 is significantly upregulated in invasive pituitary adenoma with satisfactory predictive value. It may regulate EMT. It may be a potential diagnostic marker for invasive pituitary adenoma.
Topics: Humans; Pituitary Neoplasms; Epithelial-Mesenchymal Transition; Proteomics; Biomarkers; Adenoma
PubMed: 36936141
DOI: 10.3389/fendo.2023.1137648 -
Frontiers in Endocrinology 2021Pituitary neuroendocrine tumors (PitNET) are commonly benign tumors accounting for 10-25% of intracranial tumors. Prolactin-secreting adenomas represent the most... (Review)
Review
Pituitary neuroendocrine tumors (PitNET) are commonly benign tumors accounting for 10-25% of intracranial tumors. Prolactin-secreting adenomas represent the most predominant type of all PitNET and for this subtype of tumors, the medical therapy relies on the use of dopamine agonists (DAs). DAs yield an excellent therapeutic response in reducing tumor size and hormonal secretion targeting the dopamine receptor type 2 (D2DR) whose higher expression in prolactin-secreting adenomas compared to other PitNET is now well established. Moreover, although DAs therapy does not represent the first-line therapy for other PitNET, off-label use of DAs is considered in PitNET expressing D2DR. Nevertheless, DAs primary or secondary resistance, occurring in a subset of patients, may involve several molecular mechanisms, presently not fully elucidated. Dopamine receptors (DRs) expression is a prerequisite for a proper DA function in PitNET and several molecular events may negatively modify DR membrane expression, through the DRs down-regulation and intracellular trafficking, and DR signal transduction pathway. The current mini-review will summarise the presently known molecular events that underpin the unsuccessful therapy with DAs.
Topics: ACTH-Secreting Pituitary Adenoma; Adenoma; Aminoquinolines; Bromocriptine; Cabergoline; Dopamine Agonists; Drug Resistance, Neoplasm; Filamins; Growth Hormone-Secreting Pituitary Adenoma; Humans; Lisuride; MicroRNAs; Pergolide; Pituitary Neoplasms; Prolactinoma; Receptors, Dopamine D2; beta-Arrestins
PubMed: 35095761
DOI: 10.3389/fendo.2021.791633 -
Pathologica Aug 2022Alveolar adenoma is a rare tumour of the lung. It is typically found in asymptomatic adults as a peripheral or subplerual nodule on imaging examination. Microscopically,... (Review)
Review
Alveolar adenoma is a rare tumour of the lung. It is typically found in asymptomatic adults as a peripheral or subplerual nodule on imaging examination. Microscopically, the tumour is composed of admixture of epithelial and mesenchymal component in variable sized cystic or alveolar structures. The tumour shows a benign nature. There have been no reported recurrences or metastases. Malignant transformation of alveolar adenoma and coexisting with lung carcinoma have been rarely described. In this article, we report a case of an alveolar adenoma and coexisting atypical adenomatous hyperplasia. This case, contributing to the limited numbers of cases described to date, illustrates the importance of awareness on the possibility of alveolar adenoma being associated with lung carcinoma and its precursor lesions especially when diagnosed by small biopsy specimens.
Topics: Adenoma; Adult; Carcinoma; Humans; Hyperplasia; Lung Neoplasms; Precancerous Conditions
PubMed: 36136901
DOI: 10.32074/1591-951X-755 -
Revista de Investigacion Clinica;... 2020The pituitary gland is responsible for the synthesis and secretion of various hormones that play a key role in regulating endocrine function and homeostasis. Pituitary... (Review)
Review
The pituitary gland is responsible for the synthesis and secretion of various hormones that play a key role in regulating endocrine function and homeostasis. Pituitary adenomas (PA) are benign epithelial tumors arising from the endocrine cells of the anterior pituitary gland. Clinically relevant PA are relatively common and they occur in 0.1% of the general population. They are mostly benign monoclonal neoplasms that arise from any of the five hormone-secreting cell types of the anterior pituitary gland. PA are categorized as either functioning or non-functioning, depending on whether or not they produce a hormonal hypersecretion syndrome. Both functioning and non-functioning adenomas can produce symptoms or signs resulting from compression of the optic chiasm or invasion of cavernous sinuses. Only 5% of PA occur within the context of hereditary syndromes with reasonably well-defined oncogenic mechanisms. The vast majority of PA are sporadic, and their etiopathogenesis remains largely unknown. Pituitary tumor oncogenesis involves several mechanisms that eventually lead to abnormal cell proliferation and dysregulated hormone production. Among these factors, we found inactivating mutations of tumor suppressor genes, activating mutation of oncogenes and the participation of hormonal signals coming from the hypothalamus, all resulting in cell-cycle regulation abnormalities. In this review, we summarize the clinical and pathophysiological aspects of the different hereditary pituitary tumor syndromes.
Topics: Adenoma; Animals; Humans; Mutation; Pituitary Gland; Pituitary Neoplasms; Syndrome
PubMed: 32132734
DOI: 10.24875/RIC.19003186 -
Journal of Veterinary Internal Medicine Jan 2022Electrolyte abnormalities, especially hypernatremia, are frequent complications after transsphenoidal hypophysectomy in dogs with pituitary-dependent hypercortisolism.
BACKGROUND
Electrolyte abnormalities, especially hypernatremia, are frequent complications after transsphenoidal hypophysectomy in dogs with pituitary-dependent hypercortisolism.
OBJECTIVES
To describe electrolyte abnormalities after transsphenoidal hypophysectomy and to investigate possible associations between postoperative hypernatremia and clinical and surgical variables as well as with postoperative outcome.
ANIMALS
One hundred and twenty-seven client-owned dogs.
METHODS
Dogs with pituitary corticotroph adenomas that underwent transsphenoidal hypophysectomy were retrospectively included. Plasma sodium and potassium concentrations were measured -2, +2, +8, +24, and +48 hours from hypophysectomy. Clinical (breed, age, body weight, skull type, urinary cortisol/creatinine ratio, percentage of suppression to dexamethasone) and surgical variables (duration of anesthesia and surgery, pituitary dimensions) were compared to the development of hypernatremia.
RESULTS
Postoperative hypernatremia developed in 46.5% (57/127) of dogs and hyponatremia in 6.3% (8/127). Plasma sodium concentration increased after surgery and peaked at 8 hours after surgery, normalizing after 24 to 48 hours. Plasma potassium concentration increased without exceeding the reference limit. No significant associations were found between clinical and surgical variables and hypernatremia, or between hypernatremia and postoperative death, long-term survival or recurrence. Surgery time was significantly longer in dogs that developed persistent diabetes insipidus (P = .02) and persistent diabetes insipidus occurred more frequently in dogs with enlarged pituitary glands (P = .01).
CONCLUSION AND CLINICAL IMPORTANCE
Hypernatremia remains a frequent postoperative complication after transsphenoidal hypophysectomy but did not appear to have an impact on postoperative outcome. No predisposing factor to postoperative hypernatremia was identified. Variations in plasma potassium concentrations do not seem to influence postoperative outcome.
Topics: ACTH-Secreting Pituitary Adenoma; Adenoma; Animals; Dog Diseases; Dogs; Hypophysectomy; Neoplasm Recurrence, Local; Postoperative Complications; Potassium; Retrospective Studies; Sodium
PubMed: 34914137
DOI: 10.1111/jvim.16337 -
Head and Neck Pathology Sep 2021Canalicular adenoma (CAD) is an uncommon benign tumor of minor salivary glands with predilection for the upper labial mucosa. An 80-year-old female presented with nine...
Canalicular adenoma (CAD) is an uncommon benign tumor of minor salivary glands with predilection for the upper labial mucosa. An 80-year-old female presented with nine submucosal nodules of the upper labial mucosa and bilateral buccal mucosa. Histopathologic examination revealed multifocal circumscribed tumor islands with a tubular growth pattern within a loose hypocellular myxoid background stroma. Interconnecting rows of columnar tumor cells imparted a canalicular morphology. In addition to the characteristic histopathologic findings, a comprehensive immunohistochemical panel supported a final diagnosis of multifocal CAD. Synchronous multifocality in CAD is an infrequent finding and this sine qua non clinicopathologic correlation article exemplifies such a case.
Topics: Adenoma; Aged, 80 and over; Female; Humans; Mouth Mucosa; Salivary Gland Neoplasms
PubMed: 33544378
DOI: 10.1007/s12105-021-01293-w