Adrenal tuberculosis: case report

Isolated adrenal tuberculosis is rare, and represents between 1-2% of the etiologies of adrenal masses called incidentalomas. A 32-year-old woman, without notable medical history, was hospitalized for pain in the left hypochondrium, lasting for two months in a context of apyrexia and weight loss amounted to 5 kg. Clinical examination was normal, but abdominopelvic CT objectified bilateral adrenal hypertrophy predominantly left with bilateral linear calcifications. The chest radiograph was normal, adrenal hormones were normal. The research of BK in sputum and urine were negative on direct examination and culture. The tuberculin was 12 mm and HIV status was negative. A left adrenal biopsy was done and histopathological study of tuberculous lesions was found confirming caseofolliculaire adrenal tuberculosis. The patient has been treated with antibacillaire with favorable evolution. In light of this observation, the authors make the point on this rare disease.     

Pericardial cyst--a clinical case.

Pericardial cysts are uncommon and benign abnormalities, usually asymptomatic, whose main interest lies in differential diagnosis with other mediastinal tumors. The authors present a case report of a 40-year-old male with a symptomatic pericardial cyst, located in the left cardiophrenic angle, which was resected by video-assisted thoracic surgery.     

Adrenal gland hemangioma: a case report

Hemangioma is a benign vascular tumor composed of angioblastic cells. The adrenal gland localization is very rare, with only fifty cases reported in literature. We report a case of adrenal gland hemangioma diagnosed in a 55-year-old woman who presented a cervical neoplasm. The non-specific imaging features, the tumor size and the clinical context led to mandatory surgical resection. The pathological examination established the diagnosis of adrenal gland hemangioma.     

Adrenal pseudocyst mimicking cancer: a case report

Adrenal cysts are infrequently observed, since less than 500 cases have been reported in Western literature. Adrenal cysts are conventionally divided into four categories: epithelial, parasitic, endothelial, and hemorrhagic. They are characterized by different etiological and pathological features. Some authors suggest that endothelial and hemorrhagic cysts are related and may represent a spectrum of lesions. We report herein the case of an adrenal hemorrhagic pseudocyst that simulated adrenocortical cancer and argue on the clinical clues for a differential diagnosis with other adrenal tumors.     

Adrenal ganglioneuroma: report of a new case

Although adrenal ganglioneuroma (GN) is a rare tumor originating from the neural crest tissue of the sympathetic nervous system, detection of this tumor has increased, as imaging procedures such as ultrasonography (US) and computed tomography (CT) have become prevalent. The clinical presentation for most patients is asymptomatic, and most of those tumors are hormone silent. We describe a case of adrenal GN incidentally diagnosed in a 68-year-old female patient. Physical examination, routine laboratory studies, and hormonal tests were within normal ranges. Abdominal CT and magnetic resonance imaging showed a solid oval tumor approximately 6 × 4 cm in the left adrenal gland without remarkable signs of malignancy. Left adrenalectomy was performed for treatment purposes. Histological diagnosis of the tumor was a ganglioneuroma originating from the adrenal medulla. Adrenal GN occurs rarely in adults and preoperative diagnosis is difficult, especially in asymptomatic cases. It needs careful evaluation and surgical treatment. According to our knowledge, this is the fifth case of adrenal GN in an adult patient from Turkey in English literature.     

Adrenal adenoma presenting with torsade de pointes--a case report

A case of primary hyperaldosteronism due to an adrenal adenoma with near syncope and torsade de pointes is described. A woman patient had a history of high blood pressure and severe hypokalemia that was the cause of her ventricular arrhythmia, which was controlled by administering potassium supplementation but no antiarrhythmic medication. Adrenal adenoma was identified on axial computerized tomography. This case report suggests that there may be a chance of complete cure from torsade de pointes if the underlying cause of QT prolongation can be identified.     

Calcified pericardial cyst--a case report and the roentgenologic and pathologic differentiation from other calcified mediastinal cysts

A case of calcified pericardial cyst is reported and is differentiated from calcified bronchogenic, enteric, thymic, terato-dermoid, and hydatid cysts by means of roentgenology and pathology.     

Adrenal leiomyoma treated by hand-assisted laparoscopic adrenalectomy: a case report

A left adrenal incidentaloma was found by abdominal ultrasound and computed tomography (CT) in a 53-year-old woman who had a history of non-insulin dependent diabetes mellitus. Abdominal CT showed a well-circumscribed adrenal mass (5.5 x 4.5 x 3.5 cm) with low density (32HU) on precontrast scan and heterogeneous enhancement on postcontrast scan. Laboratory examinations revealed a nonfunctional adrenal tumor. As the malignant potential of the tumor could not be ruled out, the patient underwent hand-assisted laparoscopic adrenalectomy. Postoperative recovery was uneventful, and pathologic examination revealed leiomyoma.     

Adrenal cortical phaeochromocytoma: a case report of a rare entity.

Adrenal cortical phaeochromocytomas (pseudo-phaeochromocytomas) are a very rare entity and a diagnostic challenge. Of the few cases previously reported, most have incomplete data or lack clinical and biochemical follow-up documenting the cure of the excess secretion of catecholamines after resection of the tumour. We report herein a 62-year-old patient with clinical and biochemical findings diagnostic of a phaeochromocytoma associated with a 2-cm adrenal mass on CT scan. Surgery revealed the presence of an adrenal cortical adenoma with positive staining for the neuroendocrine marker synaptophysin, but negative for chromogranin, as has been previously reported for these rare cortical phaeochromocytomas. After removal of the tumour the clinical symptoms resolved and biochemical markers normalized, demonstrating the causal relationship between the cortical tumour and the excess production of catecholamines.     

Adrenal cortical adenoma and adrenal medullary hyperplasia of the right adrenal gland--a case report

The normal adrenal gland contains two types of tissue, the adrenal cortical tissue and the adrenal medullary tissue. The cortex is divided into three portions: the outermost "zona glomerulosa," the central "zona fasciculata," and the innermost "zona recticularis." The adrenal medulla is a developmentally separate organ, derived from neuroectoderm, and is the site of epinephrine and norepinephrine production. Adrenal cortical adenoma is commonly the result of a basophilic tumor of the anterior pituitary that secretes excessive amounts of ACTH. Adrenal medullary hyperplasia (or pheochromocytoma) are clinically hazardous tumors because of their excessive secretion of catecholamines. Combined adrenal cortical adenoma and adrenal medullary hyperplasia of the right adrenal gland has never been described previously.     

Adrenal carcinoma causing secondary amyloidosis: report of the first case in the literature

In a 53-year-old male patient with metastatic adrenal carcinoma, treatment with mitotane was instituted but he was lost to follow-up. Two years later, he presented with oedema and nephrotic-range proteinuria. The rectal and renal biopsies revealed an accumulation of secondary amyloid material. The patient died of respiratory failure caused by the progressive pulmonary metastases. This is the first report of a patient with adrenal carcinoma who developed secondary amyloidosis.     

妊娠中期重症恙虫病1例并文献复习

<正>患者女,30岁,因"孕2产1孕22+周,发热4 d"于2016年6月30日急诊入住南方医科大学附属小榄医院产科。患者入院前4 d无明显诱因出现发热,T 39.5℃,伴干咳,无寒颤、抽搐,无腹痛、呕吐,在外院及我院门诊予对症治疗未见好转。入院查体:T39.7℃,P 82次/min,R 25次/min,BP 130/76 mm Hg。精神疲倦,双肺可闻及湿啰音。HR 82次/min,律齐,未闻及病理性杂音。腹部膨隆,肝脾触诊不满意,肠     

Adrenal insufficiency caused by primary aggressive non-Hodgkin's lymphoma of bilateral adrenal glands: report of a case and literature review

 A 64-year-old woman was hospitalized because of poor general condition, gastrointestinal upset, unexplained fever, electrolyte imbalances, and an incidental finding of bilateral huge adrenal masses on computerized tomography (CT) of the abdomen. Non-Hodgkin's lymphoma (NHL) of B-cell origin was proven by ultrasound-guided aspiration biopsy of the left adrenal gland. Meanwhile, primary adrenal insufficiency was confirmed by her low serum cortisol level, high ACTH level, and inadequate adrenal response to the rapid ACTH stimulation test. The diagnosis of primary adrenal NHL was supported by detailed physical examinations, bone marrow examination, and such imaging studies as CT scan and sonography. She received three courses of chemotherapy with cyclophosphamide, vincristine, and prednisolone and there was an initial transient response, but she died of sepsis and progression of NHL three and a half months later. Received: September 14, 1998 / Accepted: November 24, 1998     

Adrenal hemorrhage: a complication of anticoagulant therapy--a case history

A seventy-five year-old woman developed adrenal hemorrhage and acute adrenal insufficiency while receiving anticoagulant therapy. Abdominal CT scan was consistent with bilateral adrenal hemorrhage and was an important contribution to diagnosis and therapy. Acute adrenal hemorrhage should be suspected in patients, especially the elderly, who have recently begun anticoagulant therapy and develop upper abdominal pain followed by decreased sensorium, high fever, hypotension, and hyponatremia. Any consideration of the diagnosis of sepsis with shock in a recently anticoagulated elderly hospital patient should suggest the possibility of acute adrenal hemorrhage. Abdominal CT scan and a cosyntropin stimulation test should be performed to confirm the diagnosis. Failure of diagnosis has generally been associated with death in most patients, whereas prognosis in patients treated with corticosteroids is excellent.     

肾上腺皮质、髓质增生症(附9例报告)

目的探讨肾上腺皮、髓质增生症的诊断和治疗。方法测定９例高儿茶酚胺血症患者血浆去甲肾上腺素（ＮＥ）、肾上腺素（Ｅ）、多巴胺（ＤＡ）及２４小时尿３甲氧４羟苦杏仁酸（ＶＭＡ）、１７羟皮质类固醇（１７ＯＨＣＳ）、１７酮类固醇（１７ＫＳ）含量；作肾上腺ＣＴ扫描和同位素间位碘苄胍（１３１ＩＭＩＢＧ）显像；术中作冰冻切片检查。结果ＮＥ、Ｅ、ＤＡ、ＶＭＡ均升高，Ｅ尤为明显，１７ＯＨＣＳ、１７ＫＳ正常或升高。ＣＴ扫描肾上腺弥漫性增大、增厚，准确率８３％；１３１ＩＭＩＢＧ肾上腺显像示踪剂在２４～４８小时呈１～３级浓集，准确率９４％。病理报告：９例１７侧肾上腺皮质束状带及头、体、尾部髓质增生。结论肾上腺皮、髓质增生８９％为双侧病变，临床表现儿茶酚胺增多症，有否皮质醇症取决于皮质增生的类型，弥漫性增生者常出现症状，而结节状增生者症状不明显。认为本病的诊断首选ＣＴ和１３１ＩＭＩＢＧ。主张术中采用连续冰冻切片检查以决定肾上腺的切除范围，对增生明显的一侧腺体作全切除，另一侧作次全切除。     

华支睾吸虫病1例报告

患者曹某,男,28岁,省木综厂工人。从小在遂宁县农村长大,有在溪河边捉鱼煎烤的嗜好。在工作后还常利用业余时间到河塘捕捉鱼虾做烧烤出售。近2月来患者有反复纳差、食欲不振、腹泻、上腹疼痛、腹胀、肝区不适等症状。近日患者因腹泻、乏力加剧伴呕吐来院就诊。患者表现神差,消瘦,巩膜及皮肤轻度黄染,肝于肋下1.5cm,疑为黄疸性肝炎。实验室检查结果:黄疸指数16单位,总胆红素27μmol/L,谷丙转氨酶56单位。小便常规正常,大便常规经生理盐水直接涂片查见华支睾吸虫卵。当即送患者到四川省寄生虫病防治研究所做进一步检查。用Kato-Katz氏法查获…