Sandbox:Hannan: Difference between revisions

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* ↑ Plasma cortisol
* ↑ Plasma cortisol
* ↑ 24 Hour urinary cortisol
* ↑ 24 Hour urinary cortisol
* ↓ Plasma ACTH
* ↓ or inappropriately normal plasma ACTH
* ↑ Blood glucose
* ↑ Blood glucose
* ↓
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* Yellow fat
* Yellow fat
* Brown discoloration
* Brown discoloration
* Large cells with increased lipid contetnt (''zona fasciculata)''
* May contain pigment (lipofuscin)
* Adjacent atrophied cells
* Hemorrhage and calcification (Pre-malignant lesions)
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* Adrenal mass or nodule
* Adrenal mass or nodule
Line 117: Line 120:
* Dual-energy X-ray absorptiometry
* Dual-energy X-ray absorptiometry
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|
* N/A
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|
* Associated with Carney complex
* Associated with MEN-1
* Plasma levels of cortisol and ACTH may show false positive and false negative results due to normal diurnal hormonal variation
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|Sex steroids
|Sex steroids

Revision as of 17:55, 31 January 2019

Cortex Product Clinical manifestations Dianosis Gold

standard

Other features
Symptoms Signs Blood & Urine Histopathological Imaging Others
Adenoma Aldosterone
  • Headache
  • Vision problems
  • Muscle cramps
  • Muscle weakness & cramps
  • Numbness
  • Temporary paralysis
  • Polyuria and polydipsia
  • Hypertension
  • Refractory hypertension
  • Hypokalemia
  • Alkalosis
  • ↑ Plasma aldosterone
  • ↓ Plasma Renin
  • ↑ ARR
  • Single or multiple nodules
  • Encapsulated
  • Abundant clear cytoplasm
  • Uniforming nuclei
  • Histopathology may resemble:
    • ZF (large, lipid-laden clear cells)
    • ZG (small, compact cells with moderate amount of lipid)
    • ZR (lipid-sparse cytoplasm)
  • Adrenal mass or nodule
  • Unilateral or bilateral adrenal atrophy
  • Hypodense mass (CT)
  • Iso and low FDG uptake compared with liver (FDG PET/CT)
  • Hyperintense on in-phase and hypointense on oppose-phase (MRI)
  • Fludrocortisone Suppression Testing
  • Oral Sodium Loading
  • Saline Infusion Testing
  • Captopril test
  • Adrenal venous sampling
  • Posture test
  • Genetic testing
  • Immunohistochemical staining
  • Fludrocortisone Suppression Testing
  • Glucocorticoid-Remediable Aldosteronism responds to glucocorticoids
  • Higher cardiovascular and cerebrovascular morbidity
Cortisol
  • Weight gain
  • Growth retardation
  • Headaches
  • Amenorrhea
  • Virilization (rare)
  • Acne
  • Violaceous striae
  • Acanthosis nigricans
  • Sleep disruption
  • Mental changes
  • Muscular weakneness
  • Hypertension
  • Hirsutism
  • Hypogonadism
  • Growth retardation
  • Facial plethora
  • Acne
  • Striae
  • Bruising
  • Acanthosis nigricans
  • Mental changes
  • Muscular weakneness
  • ↑ Plasma cortisol
  • ↑ 24 Hour urinary cortisol
  • ↓ or inappropriately normal plasma ACTH
  • ↑ Blood glucose
  • Yellow fat
  • Brown discoloration
  • Large cells with increased lipid contetnt (zona fasciculata)
  • May contain pigment (lipofuscin)
  • Adjacent atrophied cells
  • Hemorrhage and calcification (Pre-malignant lesions)
  • Adrenal mass or nodule
  • Unilateral or bilateral adrenal atrophy
  • ↑ Fat
  • Hypodense mass (CT)
  • Iso and low FDG uptake compared with liver (FDG PET/CT)
  • Hyperintense on in-phase and hypointense on oppose-phase (MRI)
  • Diurnal plasma cortisol variation
  • Low dose and high dose dexamethasone suppression test
  • Dexamethasone-CRH test
  • Adrenal venous sampling
  • Genetic testing
  • Immunohistochemical staining
  • Dual-energy X-ray absorptiometry
  • N/A
  • Associated with Carney complex
  • Associated with MEN-1
  • Plasma levels of cortisol and ACTH may show false positive and false negative results due to normal diurnal hormonal variation
Sex steroids
Mix
Carcinoma
Nodular

Hyperplasia

Adrenal mass Clinical manifestations Diagnosis Gold standard Other features
Symptoms Signs Blood & Urine Histopathological Imaging Others

References