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Prilozi (Makedonska Akademija Na... 2015Adrenal cystic lesions are uncommon but due to the improved radiologic imaging techniques their appearance seems to increase.
UNLABELLED
Adrenal cystic lesions are uncommon but due to the improved radiologic imaging techniques their appearance seems to increase.
MATERIAL AND METHODS
We analyzed the clinical and radiological findings of 10 patients with adrenal cysts and the pathological features of the operative material. Standard dissection procedure and paraffin embedded tissue sections were made, stained by HE and immunohistochemically with CD34, CD 31, Factor 8, Podoplanin, CKWS and AE1/AE3 RESULTS: The mean age of the patients was 40.6 years; female to male ratio was 2.3:1. All the cysts were diagnosed as cystic lesions radiologically except one. The most present clinical symptom was abdominal pain. The diameter of the cysts measured from 2 to 7 cm. Four of the cysts were diagnosed as pseudocysts and six as endothelial. Six cysts were lined by CD34(+) and CD31(+) cells, four were lined by Factor 8(+) and podoplanin(+) cells and four had no lining.
CONCLUSION
Endothelial cysts were more common cysts in our study and the immunohistochemical results suggested common vascular origin to all endothelial cysts and supported additional separation of angiomatous and lymphangiomathous adrenal vascular cysts.
Topics: Abdominal Pain; Adrenal Gland Diseases; Adrenal Glands; Adrenalectomy; Adult; Biomarkers; Cysts; Endothelial Cells; Female; Humans; Immunohistochemistry; Male; Middle Aged; Phenotype; Retrospective Studies; Tomography, X-Ray Computed; Young Adult
PubMed: 27442396
DOI: 10.1515/prilozi-2015-0078 -
Urology Journal Dec 2016Adrenal gland injury (AGI) caused by trauma may cause bleeding and life-threatening problems in children.The objective of this study was to analyze the prevalence of AGI...
PURPOSE
Adrenal gland injury (AGI) caused by trauma may cause bleeding and life-threatening problems in children.The objective of this study was to analyze the prevalence of AGI in final diagnoses of trauma.
MATERIALS AND METHODS
The records of 458 patients with abdominal trauma (out of a total 8,200 pediatric patientswith trauma of any sort), who were referred to our clinic between January 2009 and July 2014, were reviewed retrospectively.The numbers of patients with AGI and their ages, gender, trauma patterns, affected organs, pediatrictrauma scores (PTSs), and injury severity scores (ISSs) were recorded, as well as the associated ultrasound (US)and tomographic scan data, treatments, and complications. Computed tomography (CT) scans obtained after traumawere subjected to both primary and secondary evaluation.
RESULTS
In total, 28 patients with AGI were detected; their average age was 8.54 ± 4.09 (3-17) years. Twenty(71%) patients were male and 8 (29%) were female. Nineteen (68%) patients had fallen from heights; the mostcommonly injured organs were the kidneys, spleen, and lungs. Injuries were right-sided in 26 (92.9%) patients.The mean ISS was 13.2 (range 5-50) and the mean PTS 8.6 (range 0-11). Seven patients had ISS > 16 and ninehad PTS < 8. AGI was diagnosed by CT in 14 (50%) patients and in 3 (9%) by US at primary evaluation. Uponsecondary scan inspection focusing on the possibility of adrenal gland injury, such injury was ultimately detectedin 28 patients. All patients underwent conservative follow-up, and one died.
CONCLUSION
We recommend calculation of the PTS, as well as other trauma scores, when pediatric patients sufferingmultiple or blunt abdominal trauma(s) present to the emergency . In addition, we believe that in children withtrauma involving the liver, spleen or kidneys, careful evaluation using a CT scan would increase the diagnosis ofAGI and reveal a realistic rate of AGI in trauma cases.
Topics: Adolescent; Adrenal Glands; Child; Child, Preschool; Female; Humans; Male; Prevalence; Retrospective Studies; Tomography, X-Ray Computed; Ultrasonography; Wounds, Nonpenetrating
PubMed: 27928814
DOI: No ID Found -
Frontiers in Endocrinology 2021
Topics: Adrenal Cortex Function Tests; Adrenal Gland Diseases; Adrenal Glands; Adrenocorticotropic Hormone; Endocrinology; History, 20th Century; History, 21st Century; Humans; Hydrocortisone; Precision Medicine
PubMed: 34539585
DOI: 10.3389/fendo.2021.747006 -
The corticotropin-releasing factor (CRF) family of peptides as local modulators of adrenal function.Cellular and Molecular Life Sciences :... Jul 2007Corticotropin-releasing factor (CRF), also termed corticotropin-releasing hormone (CRH) or corticoliberin, is the major regulator of the adaptive response to internal or... (Review)
Review
Corticotropin-releasing factor (CRF), also termed corticotropin-releasing hormone (CRH) or corticoliberin, is the major regulator of the adaptive response to internal or external stresses. An essential component of the adaptation mechanism is the adrenal gland. CRF regulates adrenal function indirectly through the central nervous system (CNS) via the hypothalamic-pituitary-adrenal (HPA) axis and via the autonomic nervous system by way of locus coeruleus (LC) in the brain stem. Accumulating evidence suggests that CRF and its related peptides also affect the adrenals directly, i.e. not through the CNS but from within the adrenal gland where they form paracrine regulatory loops. Indeed, CRF and its related peptides, the urocortins (UCNs: UCN1, UCN2 and UCN3), their receptors CRF type 1 (CRF(1)) and 2 (CRF(2)) as well as the endogenous pseudo-receptor CRF-binding protein (CRF-BP) are all expressed in adrenal cortical, medullary chromaffin and resident immune cells. The intra-adrenal CRF-based regulatory system is complex and depends on the balance between the local concentration of CRF ligands and the availability of their receptors.
Topics: Adrenal Gland Diseases; Adrenal Glands; Animals; Corticotropin-Releasing Hormone; Humans; Immune System; Peptides
PubMed: 17453142
DOI: 10.1007/s00018-007-6555-7 -
BMC Pregnancy and Childbirth Dec 2020The fetal adrenal gland is a highly vascularized organs and develops two recognizable distinct zones in uetro, inner fetal zone (FZ) and outer definitive zone (DZ)....
BACKGROUND
The fetal adrenal gland is a highly vascularized organs and develops two recognizable distinct zones in uetro, inner fetal zone (FZ) and outer definitive zone (DZ). Based on the region supplied, middle adrenal artery (MAA) mainly contribute to FZ while inferior adrenal artery (IAA) mainly to the inferior part of DZ. The purpose of this study was to establish reference ranges of adrenal artery Doppler indices of IAA and MAA, and assess zonal difference of blood supply to fetal adrenal gland.
METHODS
The pulsatility index (PI), resistance index (RI), and systolic:diastolic ratio (S/D) of the IAA and MAA were obtained serially at 4-week intervals in normal fetuses. The MAA and IAA were referred based on the course and location in the gland: IAA referring the artery that mainly branches from the renal artery and walks along the renal upper pole, distributing the inferoposterior part of DZ in the adrenal gland while MAA as arterial blood flowing along the single central adrenal vein in the medial part of the gland. Multilevel modeling was performed to establish the gestational age-associated reference ranges for IAA and MAA. Differences in Doppler indices between the IAA and MAA were assessed.
RESULTS
One hundred sixty-eight fetuses with 843 observations were included. The IAA had a higher detection rate than the MAA (100% vs 89.2%, p < 0.05). The resistance of IAA had a reduction around 35 weeks of gestation and that of MAA remained unchanged throughout the second half of pregnancy. Lower PI, RI and S/D were observed in the MAA than in the IAA (p < 0.05) from 752 paired measurements.
CONCLUSION
There is a zonal difference in blood supply in favor of the fetal zone, which may correspond to its unique function. Reference ranges of Doppler parameters in adrenal artery maybe beneficial for further evaluation of fetal hemodynamics.
Topics: Adrenal Glands; Adult; Female; Humans; Longitudinal Studies; Middle Cerebral Artery; Pregnancy; Pulsatile Flow; Reference Values; Ultrasonography, Doppler, Color; Ultrasonography, Prenatal; Umbilical Arteries
PubMed: 33308174
DOI: 10.1186/s12884-020-03480-z -
Journal of Clinical Pathology Jan 1998CD44 is a cell surface glycoprotein found on many normal cells, mainly lymphoid and epithelial. Normal cells usually express standard CD44 (CD44-S), whereas malignant...
BACKGROUND
CD44 is a cell surface glycoprotein found on many normal cells, mainly lymphoid and epithelial. Normal cells usually express standard CD44 (CD44-S), whereas malignant tumours may express CD44 variant isoforms (CD44-V). CD44 expression has been described for neural crest derivatives. Characterisation of differences in CD44 expression may help in the diagnosis and differentiation of distinct adrenal tumours.
AIMS
To examine CD44 expression in different layers of cortical cortex, in adrenal medulla, and in adrenal tumours.
METHODS
CD44-S and CD44-V6 expression were studied in 12 cases of adrenal cortical adenoma, 3 of adrenal cortical carcinoma, 10 of pheochromocytoma, and 4 normal adrenal glands.
RESULTS
CD44-V6 staining showed cytoplasmic expression in normal adrenal cortex and in cortical adenomas and carcinomas. Pheochromocytomas also showed CD44-V6 expression but in 5 of the 10 cases it was sparse, focal, and sometimes perinuclear. Strong membranous staining for CD44-S was observed in normal adrenal medulla. Analysis of CD44-S expression revealed differences between cortical adrenal tumours and pheochromocytomas. Ten of 12 cortical adenomas and 2 of 3 cortical carcinoma cells showed weak to moderate cytoplasmic staining, but all cases of pheochromocytoma had strong membranous staining.
CONCLUSIONS
Membranous CD44-S staining may help to distinguish pheochromocytoma from adrenal cortical adenoma.
Topics: Adrenal Cortex; Adrenal Gland Neoplasms; Adrenal Glands; Adrenal Medulla; Adrenocortical Adenoma; Adrenocortical Carcinoma; Biomarkers, Tumor; Diagnosis, Differential; Humans; Hyaluronan Receptors; Neoplasm Proteins; Pheochromocytoma
PubMed: 9577373
DOI: 10.1136/jcp.51.1.52 -
JPMA. the Journal of the Pakistan... Jun 2023Adrenal Gland Cysts are rare among all the pathologic cysts that occur in human beings; the pseudo-cyst variety even rarer. Adrenal pseudo-cysts are asymptomatic,... (Review)
Review
Adrenal Gland Cysts are rare among all the pathologic cysts that occur in human beings; the pseudo-cyst variety even rarer. Adrenal pseudo-cysts are asymptomatic, non-functional, small, and incidentally discovered disease entities. Their clinical presentation is usually the result of their mass effects. Thanks to the advanced diagnostic technology, more such cases are being discovered timely and managed surgically, before life-threatening complications occur. Open surgical treatment remains the treatment of choice for giant cysts.
Topics: Humans; Adrenal Gland Diseases; Cysts; Adrenal Gland Neoplasms; Adrenalectomy; Adrenal Glands
PubMed: 37427641
DOI: 10.47391/JPMA.6896 -
Cancer Reports (Hoboken, N.J.) Feb 2021Cystic adrenal lesions are rare and uncommon manifestation with few cases reported so far. Different types of adrenal cysts have been described with heterogeneous...
BACKGROUND
Cystic adrenal lesions are rare and uncommon manifestation with few cases reported so far. Different types of adrenal cysts have been described with heterogeneous etiology and overlapping clinical findings, ranging from benign to malignant cystic neoplasm. They are usually asymptomatic or may rarely present with abdominal pain or fullness. Optimum management of adrenal cysts still remain controversial, owing to its low incidence. In this study, we report our institutional experience on diagnosis and management of different histological types of cystic adrenal lesions.
CASES
During 4 years period, 55 patients underwent adrenalectomy with five cases presenting as adrenal cysts. All the five patients were biochemically nonfunctional and underwent adrenalectomy (laparoscopic anterior n = 2, retroperitoneoscopic approach n = 1, and open anterior transperitoneal approach n = 2). The primary indications for surgery were larger size and/or suspicion of malignancy. Histological evaluation revealed two epithelial cysts, one endothelial cyst, one pseudocyst, and a very rare case of adrenocortical carcinoma arising in a pseudocyst.
CONCLUSION
Cystic adrenal lesions are rare with varied etiologic and clinical presentation that may sometimes lead to diagnostic and management dilemma. These cases must undergo biochemical and radiological evaluation to rule out underlying malignancy followed by referral for surgical intervention.
Topics: Abdominal Pain; Adrenal Gland Neoplasms; Adrenal Glands; Adrenalectomy; Adult; Asymptomatic Diseases; Carcinoma; Cysts; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 33295135
DOI: 10.1002/cnr2.1314 -
The Ceylon Medical Journal Sep 2007Hypersecretion from the adrenal glands is associated with hypertension. Causes include Conn syndrome, Cushing syndrome and phaechromocytoma. This article discusses their...
Hypersecretion from the adrenal glands is associated with hypertension. Causes include Conn syndrome, Cushing syndrome and phaechromocytoma. This article discusses their clinical features, diagnosis and treatment as well as the management of incidentally identified adrenal tumours (incidentaloma).
Topics: Adrenal Gland Diseases; Adrenal Gland Neoplasms; Adrenal Glands; Cushing Syndrome; Humans; Hyperaldosteronism; Neoplasms, Second Primary; Pheochromocytoma
PubMed: 18020030
DOI: 10.4038/cmj.v52i3.971 -
The Tohoku Journal of Experimental... Mar 2021Despite ongoing concerns regarding its clinical application, mass spectrometry (MS)-based steroid assay represents a promising tool in endocrine research. Recent studies...
Despite ongoing concerns regarding its clinical application, mass spectrometry (MS)-based steroid assay represents a promising tool in endocrine research. Recent studies indicate that monitoring the blood levels of individual sterols provides improved diagnostic insight into hyperlipidemia compared with immunoassays routinely used in clinical practice. Hypercortisolism and hyperaldosteronism can also be easily evaluated along with successful subtyping of adrenal diseases using MS-based methods, while metabolic signatures of sex steroids provide experimental evidence of abnormal puberty and male infertility. Many MS-based biological and clinical studies are based on liquid chromatography-mass spectrometry (LC-MS) coupled to electrospray ionization and tandem MS scan modes. However, gas chromatography-mass spectrometry (GC-MS) provides better chromatographic separation. Improved chromatographic resolution enables large-scale steroid profiling to allow a bird-eye view and increase the chances of identifying potent biomarkers in endocrine research. In addition to the technical advantages of MS-based assays over immunoassays, minimizing the sample amounts with acceptable analytical sensitivity and standardization of surrogate materials provides cutting-edge tools for precision and personalized medicine.
Topics: Adrenal Glands; Animals; Endocrinology; Gas Chromatography-Mass Spectrometry; Humans; Mass Spectrometry; Steroids
PubMed: 33716273
DOI: 10.1620/tjem.253.171