Sandbox:Hannan: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
No edit summary
Line 18: Line 18:
|-
|-
| rowspan="4" |Adenoma
| rowspan="4" |Adenoma
|Aldosterone<ref name="pmid26867466">{{cite journal |vauthors=Park JJ, Park BK, Kim CK |title=Adrenal imaging for adenoma characterization: imaging features, diagnostic accuracies and differential diagnoses |journal=Br J Radiol |volume=89 |issue=1062 |pages=20151018 |date=June 2016 |pmid=26867466 |pmc=5258164 |doi=10.1259/bjr.20151018 |url=}}</ref><ref name="pmid25958045">{{cite journal |vauthors=Monticone S, Castellano I, Versace K, Lucatello B, Veglio F, Gomez-Sanchez CE, Williams TA, Mulatero P |title=Immunohistochemical, genetic and clinical characterization of sporadic aldosterone-producing adenomas |journal=Mol. Cell. Endocrinol. |volume=411 |issue= |pages=146–54 |date=August 2015 |pmid=25958045 |pmc=4474471 |doi=10.1016/j.mce.2015.04.022 |url=}}</ref><ref name="pmid20498828">{{cite journal |vauthors=Stowasser M, Taylor PJ, Pimenta E, Ahmed AH, Gordon RD |title=Laboratory investigation of primary aldosteronism |journal=Clin Biochem Rev |volume=31 |issue=2 |pages=39–56 |date=May 2010 |pmid=20498828 |pmc=2874431 |doi= |url=}}</ref><ref name="pmid24605256">{{cite journal |vauthors=Guerrisi A, Marin D, Baski M, Guerrisi P, Capozza F, Catalano C |title=Adrenal lesions: spectrum of imaging findings with emphasis on multi-detector computed tomography and magnetic resonance imaging |journal=J Clin Imaging Sci |volume=3 |issue= |pages=61 |date=2013 |pmid=24605256 |pmc=3935261 |doi=10.4103/2156-7514.124088 |url=}}</ref>
|Aldosterone
|
|
* Headache
* Headache
Line 67: Line 67:
* Higher cardiovascular and cerebrovascular morbidity
* Higher cardiovascular and cerebrovascular morbidity
|-
|-
|Cortisol<ref name="pmid26867466">{{cite journal |vauthors=Park JJ, Park BK, Kim CK |title=Adrenal imaging for adenoma characterization: imaging features, diagnostic accuracies and differential diagnoses |journal=Br J Radiol |volume=89 |issue=1062 |pages=20151018 |date=June 2016 |pmid=26867466 |pmc=5258164 |doi=10.1259/bjr.20151018 |url=}}</ref><ref name="pmid18493137">{{cite journal |vauthors=Stratakis CA |title=Cushing syndrome caused by adrenocortical tumors and hyperplasias (corticotropin- independent Cushing syndrome) |journal=Endocr Dev |volume=13 |issue= |pages=117–32 |date=2008 |pmid=18493137 |pmc=3132884 |doi=10.1159/000134829 |url=}}</ref><ref name="pmid25871963">{{cite journal |vauthors=Zilbermint M, Stratakis CA |title=Protein kinase A defects and cortisol-producing adrenal tumors |journal=Curr Opin Endocrinol Diabetes Obes |volume=22 |issue=3 |pages=157–62 |date=June 2015 |pmid=25871963 |pmc=4560837 |doi=10.1097/MED.0000000000000149 |url=}}</ref><ref name="pmid29685132">{{cite journal |vauthors=Wei J, Li S, Liu Q, Zhu Y, Wu N, Tang Y, Li Q, Ren K, Zhang Q, Yu Y, An Z, Chen J, Li J |title=ACTH-independent Cushing's syndrome with bilateral cortisol-secreting adrenal adenomas: a case report and review of literatures |journal=BMC Endocr Disord |volume=18 |issue=1 |pages=22 |date=April 2018 |pmid=29685132 |pmc=5913873 |doi=10.1186/s12902-018-0250-6 |url=}}</ref>
|Cortisol<ref name="pmid26867466">{{cite journal |vauthors=Park JJ, Park BK, Kim CK |title=Adrenal imaging for adenoma characterization: imaging features, diagnostic accuracies and differential diagnoses |journal=Br J Radiol |volume=89 |issue=1062 |pages=20151018 |date=June 2016 |pmid=26867466 |pmc=5258164 |doi=10.1259/bjr.20151018 |url=}}</ref>
|
|
* Weight gain
* Weight gain
Line 126: Line 126:
* Plasma levels of cortisol and ACTH may show false positive and false negative results due to normal diurnal hormonal variation
* Plasma levels of cortisol and ACTH may show false positive and false negative results due to normal diurnal hormonal variation
|-
|-
|Sex steroids
|Androgens
|
|
* Hirsutism
* Virilization
* Amenorrhea
* Precocious puberty
|
|
* Clitorimegaly
* Male pattern baldness
* Resistant hypertension
|
|
*
|
|
|
|

Revision as of 18:43, 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[1]
  • 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
Androgens
  • Hirsutism
  • Virilization
  • Amenorrhea
  • Precocious puberty
  • Clitorimegaly
  • Male pattern baldness
  • Resistant hypertension
Mix
Carcinoma
Nodular

Hyperplasia

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

References

  1. ↑ Park JJ, Park BK, Kim CK (June 2016). "Adrenal imaging for adenoma characterization: imaging features, diagnostic accuracies and differential diagnoses". Br J Radiol. 89 (1062): 20151018. doi:10.1259/bjr.20151018. PMC 5258164. PMID 26867466.
Retrieved from "https://www.wikidoc.org/index.php?title=Sandbox:Hannan&oldid=1544263"