Abstract:
:In the majority of cases, Cushing's disease is the result of a small basophilic corticotroph microadenoma with an average size of less than 5 mm. Transsphenoidal microsurgery can cure patients with Cushing's disease; however, selective removal of the lesion requires precise preoperative localization. In this article, we present the pathological findings and clinical outcomes of four patients who underwent inferior petrosal sinus sampling (IPSS) for ACTH, pituitary imaging and subsequent transsphenoidal surgery for the diagnosis and treatment of Cushing's disease. All patients fulfilled accepted biochemical criteria for the diagnosis of ACTH-dependent Cushing's syndrome. Histological examination revealed a basophilic corticotroph adenoma in two patients. In one other patient, only Crooke's hyalinization was found; however, the patient achieved a complete clinical and biochemical remission following a hemihypophysectomy based on IPSS findings. Thus, a microadenoma was assumed or proven in three patients, of whom two were cured by surgery alone. In the third patient, cortisol excess persisted following transsphenoidal surgery because of a coexistent functioning adrenal adenoma. The fourth patient developed recurrent nodular corticotroph hyperplasia following a 17-yr remission. The second transsphenoidal procedure failed to ameliorate cortisol excess, necessitating a subsequent bilateral adrenalectomy. IPSS accurately localized the site of the lesion in all four cases. Although magnetic resonance imaging (MRI) identified a distinct lesion in three cases, two of these represented false positives (a cyst in one case and a prolactinoma in the other), whereas in only one did MRI correctly match the site of the lesion. In each case, conflicting test results and/or difficult management decisions posed a challenge. Thus, successful resolution of disease requires a multidisciplinary approach to validate clinical, biochemical, and radiographic data based on morphologic findings.
journal_name
Endocr Patholjournal_title
Endocrine pathologyauthors
Booth GL,Smyth HS,Kovacs K,Horvath E,Asa SL,Ezzat Sdoi
10.1007/BF02739828subject
Has Abstractpub_date
1999-06-01 00:00:00pages
165-71issue
2eissn
1046-3976issn
1559-0097pii
10.1007/BF02739828journal_volume
10pub_type
杂志文章abstract::The BRAF(V600E) mutation is specific for thyroid papillary cancer (PTC) and correlates with PTCs invasiveness. This study investigated whether detection of BRAF(V600E) mutation can be performed on routinely stained FNABs. We also examined if establishment of the BRAF(V600E) mutation could help in identification of pat...
journal_title:Endocrine pathology
pub_type: 杂志文章
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journal_title:Endocrine pathology
pub_type: 杂志文章
doi:10.1007/s12022-016-9422-y
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abstract::Neoplastic plasma cell involvement of thyroid is an uncommon condition, and it may involve thyroid in multiple myeloma or solitary plasmacytoma. Its clinical and pathological features are not well understood. We present a rare case of synchronous thyroid involvement in plasma cell leukemia presenting as thyroid nodule...
journal_title:Endocrine pathology
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doi:10.1007/s12022-015-9392-5
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journal_title:Endocrine pathology
pub_type: 杂志文章
doi:10.1007/s12022-009-9065-3
更新日期:2009-04-01 00:00:00
abstract::Nonradioisotopic electron microscopic (EM) in situ hybridization (ISH) (EM-SH) with biotinylated oligonucleotide probes is utilized for the ultrastructural visualization of pituitary hormone mRNA in rat pituitary cells. EMISH is an important tool for clarifying the intracellular localization of mRNA and the exact site...
journal_title:Endocrine pathology
pub_type: 杂志文章
doi:10.1007/BF02738881
更新日期:1999-10-01 00:00:00
abstract::Thyroperoxidase (TPO) is a thyroid-specific enzyme expressed by differentiated thyroid cells. Initial immunohistochemical studies claimed that TPO expression, detected by the monoclonal antibody mAb 47, may be a potentially important diagnostic tool in differentiating malignant from benign lesions. However, some recen...
journal_title:Endocrine pathology
pub_type: 杂志文章
doi:10.1385/ep:17:1:53
更新日期:2006-04-01 00:00:00
abstract::Hypophysitis is an inflammatory disease of the pituitary gland that clinically and radiologically mimics pituitary tumors. We report here a case of xanthogranulomatous hypophysitis mimicking a pituitary neoplasm.A 65-yr-old woman presented with weight loss, fatigue, and visual disturbance. Computed tomography demonstr...
journal_title:Endocrine pathology
pub_type: 杂志文章
doi:10.1385/ep:15:4:351
更新日期:2004-01-01 00:00:00
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journal_title:Endocrine pathology
pub_type: 历史文章,杂志文章
doi:10.1007/s12022-013-9284-5
更新日期:2014-03-01 00:00:00
abstract::Synchronous occurrence of medullary and papillary carcinoma of the thyroid gland is very rare. We describe two cases of synchronous medullary and papillary carcinoma of the thyroid. In both cases, medullary carcinoma and papillary carcinoma were separate in the thyroid but mixed in some of the lymph node metastases. A...
journal_title:Endocrine pathology
pub_type: 杂志文章
doi:10.1385/ep:15:1:83
更新日期:2004-04-01 00:00:00
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journal_title:Endocrine pathology
pub_type: 杂志文章
doi:10.1007/s12022-018-9549-0
更新日期:2018-12-01 00:00:00
abstract::Transcription factors play specific roles in the development and differentiation of normal pituitary tissues and pituitary adenoma. The transcription factor, muscle segment homeobox 1 (MSX1), which belongs to the homeobox gene family, binds the promoter region of the glycoprotein hormone alpha-subunit (SU) in TSH-prod...
journal_title:Endocrine pathology
pub_type: 杂志文章
doi:10.1007/s12022-008-9021-7
更新日期:2008-04-01 00:00:00
abstract::The purpose of this study is to describe a case of concurrent medullary and papillary thyroid carcinoma (MTC and PTC) and cutaneous melanoma and to analyze BRAF(V600E) mutation in plasma and tissues. We report the clinical history and the laboratory, imaging, and histopathological findings of a 47-year-old man affecte...
journal_title:Endocrine pathology
pub_type: 杂志文章,评审
doi:10.1007/s12022-014-9303-1
更新日期:2014-09-01 00:00:00
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journal_title:Endocrine pathology
pub_type: 杂志文章
doi:10.1385/ep:13:2:125
更新日期:2002-07-01 00:00:00
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journal_title:Endocrine pathology
pub_type: 杂志文章
doi:10.1007/s12022-018-9559-y
更新日期:2019-03-01 00:00:00
abstract::We report a very rare case of Cushing's syndrome caused by an ileal adrenocorticotrophin-secreting well-differentiated endocrine carcinoma with liver metastases. A 62-yr-old woman presented with clinical and biological signs suggestive of paraneoplastic Cushing's syndrome Radiological investigations, including magneti...
journal_title:Endocrine pathology
pub_type: 杂志文章
doi:10.1385/ep:11:4:359
更新日期:2000-01-01 00:00:00
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journal_title:Endocrine pathology
pub_type: 杂志文章
doi:10.1007/s12022-009-9079-x
更新日期:2009-10-01 00:00:00
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journal_title:Endocrine pathology
pub_type: 杂志文章
doi:10.1007/s12022-018-9540-9
更新日期:2018-12-01 00:00:00
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journal_title:Endocrine pathology
pub_type: 杂志文章
doi:10.1007/BF02739959
更新日期:1998-10-01 00:00:00
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journal_title:Endocrine pathology
pub_type: 杂志文章
doi:10.1007/s12022-002-0002-y
更新日期:2002-10-01 00:00:00
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journal_title:Endocrine pathology
pub_type: 杂志文章
doi:10.1385/ep:11:2:145
更新日期:2000-07-01 00:00:00
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journal_title:Endocrine pathology
pub_type: 杂志文章
doi:10.1385/ep:16:4:331
更新日期:2005-01-01 00:00:00
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journal_title:Endocrine pathology
pub_type: 杂志文章
doi:10.1007/s12022-010-9142-7
更新日期:2011-03-01 00:00:00
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journal_title:Endocrine pathology
pub_type: 杂志文章
doi:10.1007/s12022-008-9024-4
更新日期:2008-10-01 00:00:00
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journal_title:Endocrine pathology
pub_type: 杂志文章
doi:10.1007/s12022-020-09612-7
更新日期:2020-06-01 00:00:00
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journal_title:Endocrine pathology
pub_type: 杂志文章
doi:10.1007/BF02921487
更新日期:1994-12-01 00:00:00
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journal_title:Endocrine pathology
pub_type: 杂志文章
doi:10.1007/s12022-016-9433-8
更新日期:2016-09-01 00:00:00
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journal_title:Endocrine pathology
pub_type: 杂志文章
doi:10.1007/s12022-017-9487-2
更新日期:2017-09-01 00:00:00
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journal_title:Endocrine pathology
pub_type: 杂志文章
doi:10.1007/s12022-017-9483-6
更新日期:2017-06-01 00:00:00
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journal_title:Endocrine pathology
pub_type: 杂志文章
doi:10.1007/BF02738728
更新日期:1995-01-01 00:00:00
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journal_title:Endocrine pathology
pub_type: 杂志文章
doi:10.1007/s12022-011-9162-y
更新日期:2011-09-01 00:00:00