The expression of angiotensin Ⅱ type 1 receptor (AT1R) and angiotensin Ⅱ type 2 receptor (AT2R) in aldosterone-producing adenoma (APA) of the adrenal gland was detected, and their relationship with clinical indexes ...The expression of angiotensin Ⅱ type 1 receptor (AT1R) and angiotensin Ⅱ type 2 receptor (AT2R) in aldosterone-producing adenoma (APA) of the adrenal gland was detected, and their relationship with clinical indexes of APA was analyzed. The mRNA expression of AT1R and AT2R in 50 cases of APA and tissues adjacent to tumors and 12 cases of normal adrenal tissues was detected by using reverse transcriptase polymerase chain reaction (RT-PCR). The expression of AT1R and AT2R proteins in paraffin-embedded slices of tissue was detected by immunohistochemistry. The expression of AT1R in adenoma, tissues adjacent to tumor, and normal tissues of the adrenal gland showed no significant differences. The expression of AT2R in APA tissue was lower than that in normal adrenal gland tissues (P<0.05). Correlation analysis of the mRNA expression level of AT2R and clinical data from patients demonstrated that AT2R expression was negatively related to plasma aldosterone concentration (PAC) (r=-0.467, P<0.05), but positively related with plasma renin activity (PRA) (r=0.604, P<0.05). It is concluded that down-regulation of the AT2R expression is possibly related with the tumorigenesis of APA.展开更多
A prospective study of 15 dogs with diagnosed Cushing’s syndrome was made to find a correlation between adrenal size enlargement, clinical signs and results of an ACTH stimulation test. To our knowledge, no study was...A prospective study of 15 dogs with diagnosed Cushing’s syndrome was made to find a correlation between adrenal size enlargement, clinical signs and results of an ACTH stimulation test. To our knowledge, no study was made trying to correlate changes in adrenal size, response to therapy and ACTH stimulation test results. Ultrasonographic evaluation and an endocrine test (ACTH stimulation test/“pre pill”) were performed in each dog two weeks after initiating the therapy, two to four weeks after changing the dosage of trilostane and ideally 10 weeks after establishing the right dosage of trilostane (two owners showed up later on date due pandemic of COVID-19). The results indicate that there is correlation between adrenal size enlargement and response to trilostane therapy. In this study, all dogs that had increase in adrenal gland size of more than 7% showed as well clinical improvement of HAC (hyperadrenocorticism) signs under trilostane therapy. Further, possible multicentric, studies should be performed to verify assumed correlation between adrenal size enlargement and positive response to trilostane therapy.展开更多
BACKGROUND Diffuse large B-cell lymphoma,which accounts for about approximately 30%to 40%of non-Hodgkin's lymphomas,is the most common type and is a class of aggressive B-cell lymphomas.However,diffuse large B-cel...BACKGROUND Diffuse large B-cell lymphoma,which accounts for about approximately 30%to 40%of non-Hodgkin's lymphomas,is the most common type and is a class of aggressive B-cell lymphomas.However,diffuse large B-cell lymphomas primary to the adrenal gland are rare.CASE SUMMARY A 73-year-old man was admitted with abdominal pain and fatigue.After admission,enhanced adrenal computed tomography indicated irregular masses on both adrenal glands,with the larger one on the left side,approximately 8.0 cm×4.3 cm in size.The boundary was irregular,and surrounding tissues were compressed.No obvious enhancement was observed in the arterial phase.Resection of the left adrenal gland was performed.Pathological diagnosis revealed diffuse large B-cell lymphoma.After surgery,the patient received RCHOP immunochemotherapy.During the fourth immunochemotherapy,patient condition deteriorated,and he eventually died of respiratory failure.CONCLUSION R-CHOP is the conventional immunochemotherapy for primary adrenal diffuse large B-cell lymphoma.Surgery is mainly used to diagnose the disease.Hence,the ideal treatment plan remains to be confirmed.展开更多
BACKGROUND Adrenal myelolipoma is a rare,benign,non-functioning mass that occurs in the adrenal gland.It is composed of an admixture of hematopoietic elements and mature adipose tissue,similar to bone marrow.Even at l...BACKGROUND Adrenal myelolipoma is a rare,benign,non-functioning mass that occurs in the adrenal gland.It is composed of an admixture of hematopoietic elements and mature adipose tissue,similar to bone marrow.Even at large sizes,adrenal myelolipomas are usually asymptomatic and often incidentally found by ultrasonography or computed tomography(CT)scan.This paper describes an unusual case of adrenal myelolipoma presenting as flank pain.CASE SUMMARY A 50-year-old male with severe right flank pain underwent a CT scan revealing a huge mass extending into the suprarenal space.The mass showed a fat component with retroperitoneal hemorrhage.The tumor was treated laparoscopically,and pathologic examination revealed features of myelolipoma originating from the adrenal gland.CONCLUSION Adrenal myelolipomas are generally asymptomatic and can be treated conservatively.However,rupture and hemorrhage of the tumor can cause symptoms requiring surgical removal.展开更多
Scavenger receptor class B type Ⅰ (SR-BI) is an important member of the scavenger receptor family of integral membrane glycoproteins. This review highlights studies in SR-BI knockout mice, which concern the role of S...Scavenger receptor class B type Ⅰ (SR-BI) is an important member of the scavenger receptor family of integral membrane glycoproteins. This review highlights studies in SR-BI knockout mice, which concern the role of SR-BI in cholesterol and steroid metabolism. SR-BI in hepatocytes is the sole molecule involved in selective uptake of cholesteryl esters from high-density lipoprotein (HDL). SR-BI plays a physiological role in binding and uptake of native apolipoprotein B (apoB)-containing lipoproteins by hepatocytes, which identif ies SR-BI as a multipurpose player in lipid uptake from the blood circulation into hepatocytes in mice. In adrenocortical cells, SR-BI mediates the selective uptake of HDL-cholesteryl esters, which is eff iciently coupled to the synthesis of glucocorticoids (i.e. corticosterone). SR-BI knockout mice suffer from adrenal glucocorticoid insuff iciency, which suggests that functional SR-BI protein is necessary for optimal adrenal steroidogenesis in mice. SR-BI in macrophages plays a dual role in cholesterol metabolism as it is able to take up cholesterol associated with HDL and apoBcontaining lipoproteins and can possibly facilitate cholesterol efflux to HDL. Absence of SR-BI is associated with thrombocytopenia and altered thrombosis susceptibility, which suggests a novel role for SR-BI in regulating platelet number and function in mice. Transgenic expression of cholesteryl ester transfer protein in humanized SR-BI knockout mice normalizes hepatic delivery of HDL-cholesteryl esters. However, other pathologies associated with SR-BI def iciency, i.e. increased atherosclerosis susceptibility, adrenal glucocorticoid insuffi ciency, and impaired platelet function are not normalized, which suggests an important role for SR-BI in cholesterol and steroid metabolism in man. In conclusion, generation of SR-BI knockout mice has signif icantly contributed to our knowledge of the physiological role of SR-BI. Studies using these mice have identif ied SR-BI as a multi-purpose player in cholesterol and steroid metabolism because it has distinct roles in reverse cholesterol transport, adrenal steroidogenesis, and platelet function.展开更多
Mucormycosis is a rare but invasive opportunistic fungal infection associated with a high mortality rate,and normally occurs in immunocompromised patients. In this report,we describe an immunocompetent patient sufferi...Mucormycosis is a rare but invasive opportunistic fungal infection associated with a high mortality rate,and normally occurs in immunocompromised patients. In this report,we describe an immunocompetent patient suffering from hepatic mucormycosis secondary to adrenal mucormycosis,which masquerades as hilar cholangiocarcinoma. After surgical procedure and treatment with amphotericin B and itraconazole,the patient recovered well and had a 2-year infection-free survival. To our knowledge,this special clinical manifestation of hepatic infection as well as adrenal mucormycosis has not been reported to date. Mean-while,this is the first case of an immunocompetent patient with both adrenal and hepatic mucormycosis who has been treated successfully.展开更多
BACKGROUND Retroperitoneal bronchogenic cyst(RBC)is an extremely rare developmental abnormality.Most are benign tumors but malignant transformation is possible.Because of their anatomical position,RBCs are easily misd...BACKGROUND Retroperitoneal bronchogenic cyst(RBC)is an extremely rare developmental abnormality.Most are benign tumors but malignant transformation is possible.Because of their anatomical position,RBCs are easily misdiagnosed as adrenal or pancreatic solid tumors on radiological evaluation.Here,we report a case of RBC,review the literature,and summarize some important features.CASE SUMMARY A 49-year-old woman was incidentally found to have a retroperitoneal tumor during a physical examination.Enhanced computed tomography and laboratory evaluations,including routine blood examination,blood biochemistry,24-h urine 17 ketones,17 hydroxyls,adrenocortical hormone,serum potassium concentration,serum amylase,lipase,and epithelial tumor markers,revealed a moderate density,54 mm×40 mm mass with a clear boundary near the left adrenal gland.The were no abnormalities in the blood and urine values.Because the patient had a history of hypertension and the location of the mass was adjacent to the adrenal gland,it was initially diagnosed as a left adrenal tumor and was resected by retroperitoneal laparoscopy.However,the pathological examination after surgery confirmed it to be a bronchogenic cyst.CONCLUSION Retroperitoneal laparoscopic surgery can be prioritized for symptomatic RBC patients.Conservative treatment is feasible for selected patients.展开更多
Ganglioneuroma is a rare benign tumor Neuronagliomas of the adrenal gland are a rare pathology. Therefore, this case will be of interest to urologists, surgeons, oncologists, and pathologists. Located in the adrenal g...Ganglioneuroma is a rare benign tumor Neuronagliomas of the adrenal gland are a rare pathology. Therefore, this case will be of interest to urologists, surgeons, oncologists, and pathologists. Located in the adrenal gland (20%), along the sympathetic chain, and particularly in the posterior mediastinum (40%) and the retroperitoneum (30%). Ganglioneuroma poses a positive diagnostic and therapeutic problem. We report the case of a patient aged 48 admitted for pain in the right hypochondrium. He had no significant past medical or surgical history. On a physical examination, there were no noticeable findings except for mild tenderness and a mass on palpation. He underwent abdominal CT, which showed a relatively homogenous right adrenal tumor measuring. Endocrine work-up including urine catecholamine and cortisol levels was normal. Due to the tumor size and with consideration of the differential diagnosis of a malignant lesion, we elected to operate on the patient. Right adrenalectomy was performed, with no related complications. The final histopathologic report revealed adrenal ganglioneuroma. Although benign, the ganglioneuroma can present malignant aspects, in particular, CT scans and biological that can mislead the clinician, so histology remains the examination of choice for making the diagnosis.展开更多
Kidney-yang deficiency syndrome(KYDS)is a diagnostic pattern in the traditional Chinese medicine.Studies have shown that KYDS is related to the functional disorder of hormones of the hypothalamic-pituitary-target glan...Kidney-yang deficiency syndrome(KYDS)is a diagnostic pattern in the traditional Chinese medicine.Studies have shown that KYDS is related to the functional disorder of hormones of the hypothalamic-pituitary-target gland axes.The standard procedure used to mimic KYDS is the injection of a high dose of exogenous glucocorticoid(hydrocortisone and corticosterone).Such a model showed symptoms such as exhaustion,body twists,cold limbs,lying crowded together,decreased rectal temperature,sexual dysfunction,decreased reaction speed,reduced spontaneous activity,hair loss,loss of appetite,and weight loss.Moreover,the model manifested an imbalance in mutual control among the hormones of the pituitary-target gland axes,including adrenocorticotrophic hormone,CORT,CRH,thyroid-stimulating hormone,triiodothyronine,thyroxine,T,E2,follicle-stimulating hormone,luteinizing hormone,and 17-OHCS.展开更多
基金supported by the National Natural Science Founds for Distinguished Young Scholar of China (No. 30725040)
文摘The expression of angiotensin Ⅱ type 1 receptor (AT1R) and angiotensin Ⅱ type 2 receptor (AT2R) in aldosterone-producing adenoma (APA) of the adrenal gland was detected, and their relationship with clinical indexes of APA was analyzed. The mRNA expression of AT1R and AT2R in 50 cases of APA and tissues adjacent to tumors and 12 cases of normal adrenal tissues was detected by using reverse transcriptase polymerase chain reaction (RT-PCR). The expression of AT1R and AT2R proteins in paraffin-embedded slices of tissue was detected by immunohistochemistry. The expression of AT1R in adenoma, tissues adjacent to tumor, and normal tissues of the adrenal gland showed no significant differences. The expression of AT2R in APA tissue was lower than that in normal adrenal gland tissues (P<0.05). Correlation analysis of the mRNA expression level of AT2R and clinical data from patients demonstrated that AT2R expression was negatively related to plasma aldosterone concentration (PAC) (r=-0.467, P<0.05), but positively related with plasma renin activity (PRA) (r=0.604, P<0.05). It is concluded that down-regulation of the AT2R expression is possibly related with the tumorigenesis of APA.
文摘A prospective study of 15 dogs with diagnosed Cushing’s syndrome was made to find a correlation between adrenal size enlargement, clinical signs and results of an ACTH stimulation test. To our knowledge, no study was made trying to correlate changes in adrenal size, response to therapy and ACTH stimulation test results. Ultrasonographic evaluation and an endocrine test (ACTH stimulation test/“pre pill”) were performed in each dog two weeks after initiating the therapy, two to four weeks after changing the dosage of trilostane and ideally 10 weeks after establishing the right dosage of trilostane (two owners showed up later on date due pandemic of COVID-19). The results indicate that there is correlation between adrenal size enlargement and response to trilostane therapy. In this study, all dogs that had increase in adrenal gland size of more than 7% showed as well clinical improvement of HAC (hyperadrenocorticism) signs under trilostane therapy. Further, possible multicentric, studies should be performed to verify assumed correlation between adrenal size enlargement and positive response to trilostane therapy.
基金Supported by National Natural Science Foundation of China,No.82060464 and No.81972395.
文摘BACKGROUND Diffuse large B-cell lymphoma,which accounts for about approximately 30%to 40%of non-Hodgkin's lymphomas,is the most common type and is a class of aggressive B-cell lymphomas.However,diffuse large B-cell lymphomas primary to the adrenal gland are rare.CASE SUMMARY A 73-year-old man was admitted with abdominal pain and fatigue.After admission,enhanced adrenal computed tomography indicated irregular masses on both adrenal glands,with the larger one on the left side,approximately 8.0 cm×4.3 cm in size.The boundary was irregular,and surrounding tissues were compressed.No obvious enhancement was observed in the arterial phase.Resection of the left adrenal gland was performed.Pathological diagnosis revealed diffuse large B-cell lymphoma.After surgery,the patient received RCHOP immunochemotherapy.During the fourth immunochemotherapy,patient condition deteriorated,and he eventually died of respiratory failure.CONCLUSION R-CHOP is the conventional immunochemotherapy for primary adrenal diffuse large B-cell lymphoma.Surgery is mainly used to diagnose the disease.Hence,the ideal treatment plan remains to be confirmed.
基金Supported by a National Research Foundation of Korea(NRF)Grant Funded by the Korean Government(Ministry of Science and ICT),No.2019R1G1A1100422.
文摘BACKGROUND Adrenal myelolipoma is a rare,benign,non-functioning mass that occurs in the adrenal gland.It is composed of an admixture of hematopoietic elements and mature adipose tissue,similar to bone marrow.Even at large sizes,adrenal myelolipomas are usually asymptomatic and often incidentally found by ultrasonography or computed tomography(CT)scan.This paper describes an unusual case of adrenal myelolipoma presenting as flank pain.CASE SUMMARY A 50-year-old male with severe right flank pain underwent a CT scan revealing a huge mass extending into the suprarenal space.The mass showed a fat component with retroperitoneal hemorrhage.The tumor was treated laparoscopically,and pathologic examination revealed features of myelolipoma originating from the adrenal gland.CONCLUSION Adrenal myelolipomas are generally asymptomatic and can be treated conservatively.However,rupture and hemorrhage of the tumor can cause symptoms requiring surgical removal.
基金Supported by Top Institute Pharma (TIPharma Project T2-110 Hoekstra M and Van Berkel TJC)+2 种基金Grant 2008T070 from the Netherlands Heart Foundation (Hoekstra M)VIDI Grant 917.66.301 from the Netherlands Organization for Scientific Research (Van Eck M)Van Eck Mis an Established Investigator of the Netherlands Heart Foundation (Grant 2007T056)
文摘Scavenger receptor class B type Ⅰ (SR-BI) is an important member of the scavenger receptor family of integral membrane glycoproteins. This review highlights studies in SR-BI knockout mice, which concern the role of SR-BI in cholesterol and steroid metabolism. SR-BI in hepatocytes is the sole molecule involved in selective uptake of cholesteryl esters from high-density lipoprotein (HDL). SR-BI plays a physiological role in binding and uptake of native apolipoprotein B (apoB)-containing lipoproteins by hepatocytes, which identif ies SR-BI as a multipurpose player in lipid uptake from the blood circulation into hepatocytes in mice. In adrenocortical cells, SR-BI mediates the selective uptake of HDL-cholesteryl esters, which is eff iciently coupled to the synthesis of glucocorticoids (i.e. corticosterone). SR-BI knockout mice suffer from adrenal glucocorticoid insuff iciency, which suggests that functional SR-BI protein is necessary for optimal adrenal steroidogenesis in mice. SR-BI in macrophages plays a dual role in cholesterol metabolism as it is able to take up cholesterol associated with HDL and apoBcontaining lipoproteins and can possibly facilitate cholesterol efflux to HDL. Absence of SR-BI is associated with thrombocytopenia and altered thrombosis susceptibility, which suggests a novel role for SR-BI in regulating platelet number and function in mice. Transgenic expression of cholesteryl ester transfer protein in humanized SR-BI knockout mice normalizes hepatic delivery of HDL-cholesteryl esters. However, other pathologies associated with SR-BI def iciency, i.e. increased atherosclerosis susceptibility, adrenal glucocorticoid insuffi ciency, and impaired platelet function are not normalized, which suggests an important role for SR-BI in cholesterol and steroid metabolism in man. In conclusion, generation of SR-BI knockout mice has signif icantly contributed to our knowledge of the physiological role of SR-BI. Studies using these mice have identif ied SR-BI as a multi-purpose player in cholesterol and steroid metabolism because it has distinct roles in reverse cholesterol transport, adrenal steroidogenesis, and platelet function.
文摘Mucormycosis is a rare but invasive opportunistic fungal infection associated with a high mortality rate,and normally occurs in immunocompromised patients. In this report,we describe an immunocompetent patient suffering from hepatic mucormycosis secondary to adrenal mucormycosis,which masquerades as hilar cholangiocarcinoma. After surgical procedure and treatment with amphotericin B and itraconazole,the patient recovered well and had a 2-year infection-free survival. To our knowledge,this special clinical manifestation of hepatic infection as well as adrenal mucormycosis has not been reported to date. Mean-while,this is the first case of an immunocompetent patient with both adrenal and hepatic mucormycosis who has been treated successfully.
文摘BACKGROUND Retroperitoneal bronchogenic cyst(RBC)is an extremely rare developmental abnormality.Most are benign tumors but malignant transformation is possible.Because of their anatomical position,RBCs are easily misdiagnosed as adrenal or pancreatic solid tumors on radiological evaluation.Here,we report a case of RBC,review the literature,and summarize some important features.CASE SUMMARY A 49-year-old woman was incidentally found to have a retroperitoneal tumor during a physical examination.Enhanced computed tomography and laboratory evaluations,including routine blood examination,blood biochemistry,24-h urine 17 ketones,17 hydroxyls,adrenocortical hormone,serum potassium concentration,serum amylase,lipase,and epithelial tumor markers,revealed a moderate density,54 mm×40 mm mass with a clear boundary near the left adrenal gland.The were no abnormalities in the blood and urine values.Because the patient had a history of hypertension and the location of the mass was adjacent to the adrenal gland,it was initially diagnosed as a left adrenal tumor and was resected by retroperitoneal laparoscopy.However,the pathological examination after surgery confirmed it to be a bronchogenic cyst.CONCLUSION Retroperitoneal laparoscopic surgery can be prioritized for symptomatic RBC patients.Conservative treatment is feasible for selected patients.
文摘Ganglioneuroma is a rare benign tumor Neuronagliomas of the adrenal gland are a rare pathology. Therefore, this case will be of interest to urologists, surgeons, oncologists, and pathologists. Located in the adrenal gland (20%), along the sympathetic chain, and particularly in the posterior mediastinum (40%) and the retroperitoneum (30%). Ganglioneuroma poses a positive diagnostic and therapeutic problem. We report the case of a patient aged 48 admitted for pain in the right hypochondrium. He had no significant past medical or surgical history. On a physical examination, there were no noticeable findings except for mild tenderness and a mass on palpation. He underwent abdominal CT, which showed a relatively homogenous right adrenal tumor measuring. Endocrine work-up including urine catecholamine and cortisol levels was normal. Due to the tumor size and with consideration of the differential diagnosis of a malignant lesion, we elected to operate on the patient. Right adrenalectomy was performed, with no related complications. The final histopathologic report revealed adrenal ganglioneuroma. Although benign, the ganglioneuroma can present malignant aspects, in particular, CT scans and biological that can mislead the clinician, so histology remains the examination of choice for making the diagnosis.
基金funded by the Shanghai Three-Year development plan project for TCM ZY(2018–2020)-CCCX-2001-05the Clinical Characteristic Project of Acupuncture and Moxibustion of Pudong New District(PDZY-2018-0610)
文摘Kidney-yang deficiency syndrome(KYDS)is a diagnostic pattern in the traditional Chinese medicine.Studies have shown that KYDS is related to the functional disorder of hormones of the hypothalamic-pituitary-target gland axes.The standard procedure used to mimic KYDS is the injection of a high dose of exogenous glucocorticoid(hydrocortisone and corticosterone).Such a model showed symptoms such as exhaustion,body twists,cold limbs,lying crowded together,decreased rectal temperature,sexual dysfunction,decreased reaction speed,reduced spontaneous activity,hair loss,loss of appetite,and weight loss.Moreover,the model manifested an imbalance in mutual control among the hormones of the pituitary-target gland axes,including adrenocorticotrophic hormone,CORT,CRH,thyroid-stimulating hormone,triiodothyronine,thyroxine,T,E2,follicle-stimulating hormone,luteinizing hormone,and 17-OHCS.
