Abstract:
:Endogenous Cushing's syndrome is a rare endocrine disorder that incurs significant cardiovascular morbidity and mortality, due to glucocorticoid excess. It comprises adrenal (20%) and non-adrenal (80%) aetiologies. While the majority of cases are attributed to pituitary or ectopic corticotropin (ACTH) overproduction, primary cortisol-producing adrenal cortical lesions are increasingly recognised in the pathophysiology of Cushing's syndrome. Our understanding of this disease has progressed substantially over the past decade. Recently, important mechanisms underlying the pathogenesis of adrenal hypercortisolism have been elucidated with the discovery of mutations in cyclic AMP signalling (PRKACA, PRKAR1A, GNAS, PDE11A, PDE8B), armadillo repeat containing 5 gene (ARMC5) a putative tumour suppressor gene, aberrant G-protein-coupled receptors, and intra-adrenal secretion of ACTH. Accurate subtyping of Cushing's syndrome is crucial for treatment decision-making and requires a complete integration of clinical, biochemical, imaging and pathology findings. Pathological correlates in the adrenal glands include hyperplasia, adenoma and carcinoma. While the most common presentation is diffuse adrenocortical hyperplasia secondary to excess ACTH production, this entity is usually treated with pituitary or ectopic tumour resection. Therefore, when confronted with adrenalectomy specimens in the setting of Cushing's syndrome, surgical pathologists are most commonly exposed to adrenocortical adenomas, carcinomas and primary macronodular or micronodular hyperplasia. This review provides an update on the rapidly evolving knowledge of adrenal Cushing's syndrome and discusses the clinicopathological correlations of this important disease.
journal_name
J Clin Patholjournal_title
Journal of clinical pathologyauthors
Duan K,Gomez Hernandez K,Mete Odoi
10.1136/jclinpath-2014-202612subject
Has Abstractpub_date
2015-03-01 00:00:00pages
175-86issue
3eissn
0021-9746issn
1472-4146pii
jclinpath-2014-202612journal_volume
68pub_type
杂志文章,评审abstract::Improvements in the Zimmermann reaction are effected by using methanol as a solvent for the reagents employed in the reaction in place of ethanol or aqueous ethanol. The advantages are as follows. Considerably lower blanks are obtained; extraneous chromogens are negligible at the wavelength of measurement, so that no ...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.15.6.574
更新日期:1962-11-01 00:00:00
abstract::Squamous cell carcinoma arising in ovarian endometriosis is extremely rare, but a case is reported in a 62 year old woman. If such an ovarian tumour is discovered evidence of teratoma, Brenner tumour, or endometriosis should be sought. Extensive sampling is mandatory as the developing tumour often overgrows the foci o...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.44.11.958
更新日期:1991-11-01 00:00:00
abstract::Staining with naphthol AS phosphate and Fast Blue BB salt has been used for the estimation of neutrophil alkaline phosphatase (NAP) scores in patients with chronic granulocytic leukaemia (CGL). The very low scores found at diagnosis rise when the disease is treated, and there is some inverse correlation between the NA...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.28.7.517
更新日期:1975-07-01 00:00:00
abstract:AIMS:To determine important factors influencing recurrence after local excision of duct carcinoma in situ (DCIS) of the breast. MATERIALS AND METHODS:The extent (size) in millimetres, classification (by cytonuclear grade (NHSBSP system), by extent of necrosis, and by the Van Nuys system), and excision margins of 115 c...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.55.8.581
更新日期:2002-08-01 00:00:00
abstract::A manual system of microbiology reporting with a National Cash Register (NCR) form with printed names of bacteria and antiboitics required less time to compose reports than a previous manual system that involved rubber stamps and handwriting on plain report sheets. The NCR report cost 10-28 pence and, compared with a ...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.29.6.553
更新日期:1976-06-01 00:00:00
abstract:AIMS:The aim of this study was to evaluate the mismatch repair gene expression and their correlation with NF-kB in patients with oral squamous cell carcinoma (SCC). METHODS:Total RNA was isolated from 28 biopsy samples. A control group was composed of 20 volunteers. Differential expression of hMSH2, hMSH6 and NF-kB ge...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jclinpath-2019-206161
更新日期:2020-05-01 00:00:00
abstract::Formalin fixation followed by routine paraffin embedding allows the demonstration of intracellular immunoglobulin by a sandwich technique using either peroxidase or fluorescein isothyocyanate labelled antibody conjugates. The results compared favourably with those obtained using either the fresh frozen or the Sainte-M...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.27.7.548
更新日期:1974-07-01 00:00:00
abstract:AIM:To establish the diagnostic value of in situ hybridisation and the nested polymerase chain reaction (PCR) in detecting clinically relevant cytomegalovirus (CMV) infection in upper gastrointestinal biopsies from heart transplant patients. METHODS:Test sensitivity and specificity for detection of CMV early gene RNA ...
journal_title:Journal of clinical pathology
pub_type: 临床试验,杂志文章
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更新日期:1998-11-01 00:00:00
abstract::A case of coexistent acute myeloid leukaemia and sarcoidosis is reported. This was complicated by recurrent pulmonary haemorrhage during reinduction and consolidation chemotherapy. A review of published papers on malignancy and sarcoidosis, in particular acute leukaemia is given. The outcome of most cases of acute leu...
journal_title:Journal of clinical pathology
pub_type: 杂志文章,评审
doi:10.1136/jcp.47.7.672
更新日期:1994-07-01 00:00:00
abstract::Serum glycocholic acid (SGC) was measured by radioimmunoassay in 277 samples from 122 children with hepatobiliary disorders and from 23 healthy age-matched controls. In patients with hepatobiliary disease the SGC was more frequently abnormal (83%) than values for serum albumin (7%), prothrombin time (17%), bilirubin (...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.35.9.1011
更新日期:1982-09-01 00:00:00
abstract:AIMS:To assess the consistency and reproducibility of assessment of c-erbB-2 immunostaining, and to examine some of the problems relating to inter- and intraobserver variability in the documentation of positive staining; to profile the spectrum of cytoplasmic and membranous staining in a wide range of tumour types. ME...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.47.9.816
更新日期:1994-09-01 00:00:00
abstract:AIMS:To ascertain the effect of enhanced surveillance following an outbreak of waterborne cryptosporidiosis on the number of faecal specimens submitted to the local microbiology laboratory and the number positive for common enteric pathogens. The outbreak provided an opportunity to estimate the extent of routine under ...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.55.4.271
更新日期:2002-04-01 00:00:00
abstract::The development and evaluation of a new selective medium for Streptococcus pneumoniae is described. It is shown that the new medium (crystal violet-nalidixic acid-gentamicin agar:CVNG) is highly selective for Strep. pneumoniae in sputum specimens containing other organisms and is also sensitive, being only marginally ...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.33.8.770
更新日期:1980-08-01 00:00:00
abstract::Only four cases of tracheopathia osteoplastica have been reported in Britain in the past 110 years. Ten further cases are now reported; in two the diagnosis was made at bronchoscopy. It is suggested that the reputed rarity of the condition in Britain is not the whole picture. ...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.20.6.814
更新日期:1967-11-01 00:00:00
abstract::Results of serological investigations on patients with joint pain, arthralgia or polyarthritis were analysed and this information was used to develop a diagnostic algorithm to ensure optimal utilisation of laboratory resources. Accordingly, all cases are now examined for parvovirus IgM, mycoplasma IgM and streptococca...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.48.8.777
更新日期:1995-08-01 00:00:00
abstract::The separation of mesothelial hyperplasia from early malignant mesothelioma remains one of the most difficult problems in histopathology. Inconclusive cases are termed "atypical mesothelial hyperplasia" and treated expectantly. A 49 year old male pipeline engineer was diagnosed as having atypical mesothelial hyperplas...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.52.7.535
更新日期:1999-07-01 00:00:00
abstract::An indirect method of an enzyme-linked immunosorbent assay (ELISA) is described to assess the reactivity of antisera used for the identification of peptide hormone producing cells by immunocytochemistry. Compared with radioimmunoassay and immunodiffusion, the ELISA method has the advantages of simplicity and sensitivi...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.36.4.406
更新日期:1983-04-01 00:00:00
abstract:AIMS:To determine whether the presence of disseminated bone marrow tumour cells at diagnosis is a prognostic factor for breast cancer patients at high risk of recurrence or bone metastasis, and to assess their presence as a criterion for evaluation of the potential benefits of adjuvant chemotherapy. METHODS:Multiple b...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.50.3.206
更新日期:1997-03-01 00:00:00
abstract:AIM/BACKGROUND:Several studies have suggested that Helicobacter pylori which express CagA may be more virulent than those that do not, but limited populations have been studied to date. The aim of this study was to confirm and extend the association of CagA positive H pylori strains in a different geographical area and...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.49.10.829
更新日期:1996-10-01 00:00:00
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journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.2004.016436
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abstract::Candida spp are the fourth most common group of nosocomial pathogens isolated from patients on medical, surgical, and intensive care wards. Polymicrobial candidaemia has rarely been described. The diagnosis of candidaemia from peripheral blood smears has not been widely reported. This report describes the case of a yo...
journal_title:Journal of clinical pathology
pub_type: 杂志文章,评审
doi:10.1136/jcp.2003.9340
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journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.19.6.606
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abstract::Visceral botryomycosis is rare, and documented sites are lung, brain, kidney, liver and prostate. This report describes a rare autopsy case of disseminated visceral botryomycosis, with bulky, grape-like botryomycotic vegetations in the heart, and similar abscesses in the lungs and bone marrow. This is the first such r...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.2008.057588
更新日期:2008-08-01 00:00:00
abstract::Isolates of Campylobacter jejuni, C coli, C fetus and C laridis were tested for agglutination reactions with a panel of five lectins: Arachis hypogaea, Bauhinia purpurea, Solanum tuberosum, Triticum vulgaris and Wisteria floribunda. Twenty three patterns of agglutination (lectin types) were recorded among 376 isolates...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.43.11.957
更新日期:1990-11-01 00:00:00
abstract::The changes occurring at the periphery of invasive cervical carcinomas have been studied in detail, with particular reference to the incidence of preinvasive carcinoma. The various criteria used in the cytological diagnosis of malignancy have been evaluated, and the implications of large cytological screening programm...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.18.4.414
更新日期:1965-07-01 00:00:00
abstract::Cyclospora cayetanensis is a cause of prolonged diarrhoea, mainly in travellers. Laboratory diagnosis may be achieved by a number of methods such as the staining of faecal smears by the modified Ziehl-Neelsen (ZN) technique. Safer methods using this technique have been described for the staining of acid fast bacilli a...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.49.6.511
更新日期:1996-06-01 00:00:00
abstract:BACKGROUND:Subgroups of breast cancer that have an impaired response to endocrine treatment, despite hormone receptor positivity, are still poorly defined. Breast cancer can be subdivided according to standard pathological parameters including histological type, grade, and assessment of proliferation. These parameters ...
journal_title:Journal of clinical pathology
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2005-11-01 00:00:00
abstract:AIM:To evaluate the sources of fetal haemoglobin (HbF) as an indicator in cancer. An immunohistochemical study was carried out on some of the most common kinds of cancer. All of these cancers had serologically high levels of HbF as evaluated previously. METHODS:Immunoaffinity-purified anti-HbF was immunohistochemicall...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.2005.029934
更新日期:2006-06-01 00:00:00
abstract::Using a short series of biochemical tests already in use in many routine laboratories, it is possible to identify strains of the genus Klebsiella and to differentiate K. aerogenes from other types. Marked production of slime is not peculiar to the group and colonial appearance alone is not a satisfactory basis for ide...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.17.6.617
更新日期:1964-11-01 00:00:00
abstract::The thyroids of primary thyrotoxicosis patients prepared for partial thyroidectomy with propranolol contained much more lymphoid infiltrate than those prepared with carbimazole. No relation was found between the extent of lymphoid infiltrate in the thyroid and the development of postoperative hypothyroidism either bet...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.29.5.398
更新日期:1976-05-01 00:00:00