Abstract:
:Independently, endocrinology, radiology, and nuclear medicine can not optimally differentiate the etiology of the incidental adrenal mass. Rather, the insight necessary for this task must be contributed by all three disciplines. Incidentally discovered adrenal masses are being detected at an increasing rate. This trend is expected to continue based on the incidence of adrenal masses in autopsy series and the increasing use of high resolution abdominal imaging techniques. CT and MRI are able to definitely characterize only a minority of these lesions (simple cyst, myelolipoma, obvious local malignant invasion). Biochemical screening for hormone excess is essential regardless of a nonsuggestive complete history and physical examination. An argument may be made for not further pursuing nonhypersecreting lesions with the typical features of a benign adenoma on CT scan and an attenuation value of 0 HU or less. Adrenocortical scintigraphy is recommended in all patients with normal biochemical screening tests, especially those with CT attenuation values greater than 0 HU. In this setting, we believe that the functional and anatomical information provided by NP-59 and [75Se]selenomethylnorcholesterol scintigraphy allows one to noninvasively, accurately, and less expensively (Table 9) categorize adrenal masses as benign nonhypersecretory adenomas (the vast majority) vs. a possibly malignant lesion (the minority). In the presence of normal biochemistry, a concordant NP-59 imaging pattern is diagnostic of a nonhypersecretory benign adrenal adenoma and requires no immediate therapeutic intervention. Conversely, patients with discordant patterns of NP-59 scintigraphy have lesions that carry a significant risk for malignancy, and the pursuit of a tissue diagnosis is indicated, usually by means of FNA. Normal adrenocortical tissue on cytological studies in this setting may represent inadvertent sampling of adjacent normal adrenocortical tissues or the presence of a well differentiated adrenocortical carcinoma. In patients with lesions larger than 2 cm in whom NP-59 scintigraphy is nonlateralizing, the possibility of a periadrenal or pseudoadrenal mass is likely and should prompt review, or perhaps even repeat, of high resolution adrenal imaging (occasionally angiography may be helpful). In lesions shown to be 2 cm or less in size with a nonlateralizing NP-59-scan, there is a possibility of a periadrenal or pseudoadrenal mass; however, once this is excluded it must be recognized that benign and malignant lesions, because of the limitations of scintigraphy, cannot always be clearly distinguished by this method when masses are small.(ABSTRACT TRUNCATED AT 400 WORDS)
journal_name
Endocr Revjournal_title
Endocrine reviewsauthors
Kloos RT,Gross MD,Francis IR,Korobkin M,Shapiro Bdoi
10.1210/edrv-16-4-460subject
Has Abstractpub_date
1995-08-01 00:00:00pages
460-84issue
4eissn
0163-769Xissn
1945-7189journal_volume
16pub_type
杂志文章,评审abstract::Obesity and dyslipidemia are risk factors for metabolic disorders including diabetes and cardiovascular disease. Sphingolipids such as ceramide and glucosylceramides, while being a relatively minor component of the lipid milieu in most tissues, may be among the most pathogenic lipids in the onset of the sequelae assoc...
journal_title:Endocrine reviews
pub_type: 杂志文章,评审
doi:10.1210/er.2007-0025
更新日期:2008-06-01 00:00:00
abstract::It is well known that GH is important in the regulation of longitudinal bone growth. Its role in the regulation of bone metabolism in man has not been understood until recently. Several in vivo and in vitro studies have demonstrated that GH is important in the regulation of both bone formation and bone resorption. In ...
journal_title:Endocrine reviews
pub_type: 杂志文章,评审
doi:10.1210/edrv.19.1.0324
更新日期:1998-02-01 00:00:00
abstract::In human beings, two forms of GnRH, termed GnRH-I and GnRH-II, encoded by separate genes have been identified. Although these hormones share comparable cDNA and genomic structures, their tissue distribution and regulation of gene expression are significantly dissimilar. The actions of GnRH are mediated by the GnRH rec...
journal_title:Endocrine reviews
pub_type: 杂志文章,评审
doi:10.1210/er.2003-0039
更新日期:2005-04-01 00:00:00
abstract::Insulin signaling plays a physiological role in traditional insulin target tissues controlling glucose homeostasis as well as in pancreatic β-cells and in the endothelium. Insulin signaling abnormalities may, therefore, be pathogenic for insulin resistance, impaired insulin secretion, endothelial dysfunction, and even...
journal_title:Endocrine reviews
pub_type: 杂志文章,评审
doi:10.1210/er.2011-1042
更新日期:2012-08-01 00:00:00
abstract::The past few years have provided substantial evidence for the vital role of the local tumor microenvironment for various aspects of tumor progression. With obesity and its pathophysiological sequelae still on the rise, the adipocyte is increasingly moving center stage in the context of tumor stroma-related studies. To...
journal_title:Endocrine reviews
pub_type: 杂志文章,评审
doi:10.1210/er.2010-0030
更新日期:2011-08-01 00:00:00
abstract::Spermatogenesis is the process by which a single spermatogonium develops into 256 spermatozoa, one of which will fertilize the ovum. Since the 1950s when the stages of the epithelial cycle were first described, reproductive biologists have been in pursuit of one question: How can a spermatogonium traverse the epitheli...
journal_title:Endocrine reviews
pub_type: 杂志文章,评审
doi:10.1210/er.2003-0022
更新日期:2004-10-01 00:00:00
abstract::During the past decade, possible advancement in timing of puberty has been reported in the United States. In addition, early pubertal development and an increased incidence of sexual precocity have been noticed in children, primarily girls, migrating for foreign adoption in several Western European countries. These ob...
journal_title:Endocrine reviews
pub_type: 杂志文章,评审
doi:10.1210/er.2002-0019
更新日期:2003-10-01 00:00:00
abstract::Hox genes have a well-characterized role in embryonic development, where they determine identity along the anteroposterior body axis. Hox genes are expressed not only during embryogenesis but also in the adult, where they are necessary for functional differentiation. Despite the known function of these genes as transc...
journal_title:Endocrine reviews
pub_type: 杂志文章,评审
doi:10.1210/er.2005-0018
更新日期:2006-06-01 00:00:00
abstract::This review presents a comprehensive discussion of the clinical condition of delayed puberty, a common presentation to the pediatric endocrinologist, which may present both diagnostic and prognostic challenges. Our understanding of the genetic control of pubertal timing has advanced thanks to active investigation in t...
journal_title:Endocrine reviews
pub_type: 杂志文章,评审
doi:10.1210/er.2018-00248
更新日期:2019-10-01 00:00:00
abstract::Normal development and function of the testis are controlled by endocrine and paracrine signaling pathways. Platelet-derived growth factors (PDGFs) are growth factors that mediate epithelial-mesenchymal interactions in various tissues during normal and abnormal processes such as embryo development, wound healing, tiss...
journal_title:Endocrine reviews
pub_type: 杂志文章,评审
doi:10.1210/er.2010-0004
更新日期:2010-12-01 00:00:00
abstract::It is well established that the organ damage that complicates human diabetes is caused by prolonged hyperglycemia, but the cellular and molecular mechanisms by which high levels of glucose cause tissue damage in humans are still not fully understood. The prevalent hypothesis explaining the mechanisms that may underlie...
journal_title:Endocrine reviews
pub_type: 杂志文章,评审
doi:10.1210/er.2014-1099
更新日期:2015-06-01 00:00:00
abstract::The vitamin D endocrine system is essential for calcium and bone homeostasis. The precise mode of action and the full spectrum of activities of the vitamin D hormone, 1,25-dihydroxyvitamin D [1,25-(OH)(2)D], can now be better evaluated by critical analysis of mice with engineered deletion of the vitamin D receptor (VD...
journal_title:Endocrine reviews
pub_type: 杂志文章,评审
doi:10.1210/er.2008-0004
更新日期:2008-10-01 00:00:00
abstract::Pregnancy dramatically affects the hypothalamic-pituitary-adrenal axis leading to increased circulating cortisol and ACTH levels during gestation, reaching values in the range seen in Cushing's syndrome (CS). The cause(s) of increased ACTH may include placental synthesis and release of biologically active CRH and ACTH...
journal_title:Endocrine reviews
pub_type: 杂志文章,评审
doi:10.1210/er.2004-0025
更新日期:2005-10-01 00:00:00
abstract::TRH is a tripeptide amide that functions as a neurotransmitter but also serves as a neurohormone that has a critical role in the central regulation of the hypothalamic-pituitary-thyroid axis. Hypophysiotropic TRH neurons involved in this neuroendocrine process are located in the hypothalamic paraventricular nucleus an...
journal_title:Endocrine reviews
pub_type: 杂志文章,评审
doi:10.1210/er.2013-1087
更新日期:2014-04-01 00:00:00
abstract::Gut hormones signal to the central nervous system to influence energy homeostasis. Evidence supports the existence of a system in the gut that senses the presence of food in the gastrointestinal tract and signals to the brain via neural and endocrine mechanisms to regulate short-term appetite and satiety. Recent evide...
journal_title:Endocrine reviews
pub_type: 杂志文章,评审
doi:10.1210/er.2006-0028
更新日期:2006-12-01 00:00:00
abstract::Investigations of biological programs that are controlled by gene transcription have mainly studied the regulation of transcription factors. However, there are examples in which the primary focus of biological regulation is at the level of a transcriptional coactivator. We have reviewed here the molecular mechanisms a...
journal_title:Endocrine reviews
pub_type: 杂志文章,评审
doi:10.1210/er.2002-0012
更新日期:2003-02-01 00:00:00
abstract::In recent years, ovarian tissue cryopreservation has rapidly developed as a successful method for preserving the fertility of girls and young women with cancer or benign conditions requiring gonadotoxic therapy, and is now becoming widely recognized as an effective alternative to oocyte and embryo freezing when not fe...
journal_title:Endocrine reviews
pub_type: 杂志文章
doi:10.1210/endrev/bnaa020
更新日期:2020-12-01 00:00:00
abstract::Human parturition is a complex process involving interactions between the myometrium and signals derived from the placenta, fetal membranes, and fetus. Signals originating from fetal membranes are crucial components that trigger parturition, which is clearly illustrated by the labor-initiating consequence of membrane ...
journal_title:Endocrine reviews
pub_type: 杂志文章,评审
doi:10.1210/er.2017-00188
更新日期:2018-06-01 00:00:00
abstract::Several components of the GH axis are involved in tumor progression, and GH-induced intracellular signaling has been strongly associated with breast cancer susceptibility in genome-wide association studies. In the general population, high IGF-I levels and low IGF-binding protein-3 levels within the normal range are as...
journal_title:Endocrine reviews
pub_type: 杂志文章,评审
doi:10.1210/er.2018-00166
更新日期:2019-04-01 00:00:00
abstract::Estrogens are essential for normal reproductive function. In addition, they exert important, complex, and diverse nonreproductive actions on multiple tissues. Although accumulating evidence from basic science studies using animal models suggests that estradiol plays a critical neuroprotective role against multiple typ...
journal_title:Endocrine reviews
pub_type: 杂志文章,评审
doi:10.1210/er.2004-0014
更新日期:2005-05-01 00:00:00
abstract::The major goal of this review is to summarize recent exciting findings that have been published within the past 10 years that, to our knowledge, have not been presented in detail in previous reviews and that may impact altered follicular development in polycystic ovarian syndrome (PCOS) and premature ovarian failure i...
journal_title:Endocrine reviews
pub_type: 杂志文章,评审
doi:10.1210/er.2017-00164
更新日期:2018-02-01 00:00:00
abstract::Access to effective affordable contraception is critical for individual and public health. A wide range of hormonal contraceptives (HCs), which differ in composition, concentration of the progestin component, frequency of dosage, and method of administration, is currently available globally. However, the options are r...
journal_title:Endocrine reviews
pub_type: 杂志文章,评审
doi:10.1210/er.2017-00103
更新日期:2018-02-01 00:00:00
abstract::The discovery of myostatin and our introduction to the "Mighty Mouse" over a decade ago spurred both basic and applied research and impacted popular culture as well. The myostatin-null genotype produces "double muscling" in mice and livestock and was recently described in a child. The field's rapid growth is by no mea...
journal_title:Endocrine reviews
pub_type: 杂志文章,评审
doi:10.1210/er.2008-0003
更新日期:2008-08-01 00:00:00
abstract::Rapid effects of steroid hormones result from the actions of specific receptors localized most often to the plasma membrane. Fast-acting membrane-initiated steroid signaling (MISS) leads to the modification of existing proteins and cell behaviors. Rapid steroid-triggered signaling through calcium, amine release, and k...
journal_title:Endocrine reviews
pub_type: 杂志文章,评审
doi:10.1210/er.2007-0022
更新日期:2007-12-01 00:00:00
abstract::Glucose-stimulated insulin secretion from the islet beta-cell involves a sequence of metabolic events and an interplay between a wide range of signaling pathways leading to the generation of second messengers (e.g., cyclic nucleotides, adenine and guanine nucleotides, soluble lipid messengers) and mobilization of calc...
journal_title:Endocrine reviews
pub_type: 杂志文章,评审
doi:10.1210/er.2009-0022
更新日期:2010-02-01 00:00:00
abstract::Normal reproductive function in mammals requires precise control of LH synthesis and secretion by gonadotropes of the anterior pituitary. Synthesis of LH requires expression of two genes [alpha-glycoprotein subunit (alphaGSU) and LHbeta] located on different chromosomes. Hormones from the hypothalamus and gonads modul...
journal_title:Endocrine reviews
pub_type: 杂志文章,评审
doi:10.1210/er.2003-0029
更新日期:2004-08-01 00:00:00
abstract::In humans and other mammalian species, the pool of resting primordial follicles serves as the source of developing follicles and fertilizable ova for the entire length of female reproductive life. One question that has intrigued biologists is: what are the mechanisms controlling the activation of dormant primordial fo...
journal_title:Endocrine reviews
pub_type: 杂志文章,评审
doi:10.1210/er.2008-0048
更新日期:2009-08-01 00:00:00
abstract::PRL and GH are hormones with a wide spectrum of actions. Specific receptors are widely distributed in a number of classical target organs, but other tissues that are not known targets also contain measurable binding sites or receptor mRNA. The most likely explanation is that PRL and GH cause effects that have not yet ...
journal_title:Endocrine reviews
pub_type: 杂志文章,评审
doi:10.1210/edrv-12-3-235
更新日期:1991-08-01 00:00:00
abstract::The endocrine functions of the adipose organ are widely studied at this stage. The adipose organ, and in particular adipocytes, communicate with almost all other organs. Although some adipose tissue pads assume the functions as distinct "miniorgans," adipocytes can also be present in smaller numbers interspersed with ...
journal_title:Endocrine reviews
pub_type: 杂志文章,评审
doi:10.1210/er.2006-0033
更新日期:2006-12-01 00:00:00
abstract::Immune checkpoints are small molecules expressed by immune cells that play critical roles in maintaining immune homeostasis. Targeting the immune checkpoints cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and programmed death 1 (PD-1) with inhibitory antibodies has demonstrated effective and durable antitumor ac...
journal_title:Endocrine reviews
pub_type: 杂志文章,评审
doi:10.1210/er.2018-00006
更新日期:2019-02-01 00:00:00