Immunohistochemical localization of interleukin-6 in peripheral human endocrine glands

Interleukin-6 (IL-6) is a pleiotropic cytokine with differentiation and growth-promoting effects. Extensive studies in experimental animals denote that IL-6 is produced in various endocrine organs and participates in the local control of endocrine cell function. The expression of this cytokine in human endocrine glands, however, has only been examined in a limited number of studies. We investigated the immunohistochemical expression and localization of IL-6 in a variety of peripheral human endocrine glands. In the adrenals, IL-6 immunoreactivity was detected in all three zones of the cortex. The reticularis and glomerulosa zones were more heavily stained as compared with the slight immunoreactivity of the fasciculata zone. In the adrenal medulla, chromaffin and sustentacular cells were variably positive. A substantial number of follicular thyroid cells were strongly immunoreactive for IL-6 in all normal and hyperplastic thyroids examined. Parafollicular cells were negative. Parathyroid chief cells were mildly positive; selective and more intense staining was observed in acidophilic cells. Pancreatic islet cells were variably positive. In the testis positive staining was selectively observed in both Leydig and Sertoli cells. In conclusion, IL-6 immunoreactivity is present in almost all the human endocrine glands and it expressed in a cell-specific manner. These observations provide further support for the existence of local immune-endocrine interactions.     

肾上腺髓质素在肾上腺疾病中的免疫组化研究

目的：应用免疫组织化学技术观察免疫反应性肾上腺髓质素（ir-ADM)在人正常肾上腺、良恶性肾上腺肿瘤及肾上腺皮质增生组织中的分布特点。方法：对人正常肾上腺皮质（n＝10)和髓质（n=10)、嗜铬细胞瘤（n=31)、原发性醛固酮增多症的肾上腺皮质腺瘤（n=13)和增生（n=9)、皮质醇增多症的肾上腺皮质腺瘤（n=12)、增生（n=10)和腺癌（n=4)、无功能肾上腺皮质腺癌组织（n=7)进行ir-ADM的免疫组化染色。结果：10例人正常肾上腺髓质组织均显示ir-ADM染色阳性;31例嗜铬细胞瘤组织中16例染色阳性,大部分嗜铬细胞瘤组织中的ir-ADM免疫组化染色强度低于正常肾上腺髓质组织（P＜0．01）。在嗜铬细胞瘤中阵发性高血压组阳性染色例数多于持续性高血压组（P＜0．05）;人正常肾上腺皮质及各组皮质病变组织中,ir-ADM免疫组化染色均为阴性。结论：ir-ADM在嗜铬细胞瘤组织中分布呈不均一性,可能与嗜铬细胞瘤患者血压表现的多样化有关,应进一步探讨ADM在嗜铬细胞瘤发病中的病理生理作用。     

Incidental lipoma-like hibernoma arising from the adrenal gland: A well-differentiated liposarcoma mimicker

Hibernomas are uncommon benign lipomatous tumors which show differentiation toward brown fat. To our knowledge, only one case of adrenal hibernoma has been previously reported. We describe a 55-year-old woman showing an incidental, 1.7 cm-hibernoma associated with a 2.6 cm-cortical adenoma producing primary hyperaldosteronism (Conn's syndrome), both in the left adrenal gland. The hibernoma was composed predominantly of univacuolated mature fat cells admixed with small vessels. Scattered areas composed of large multivacuolated pale cells with central or paracentral nuclei, mimicking lipoblasts, accounting for less than 30% of the tumor, were found. These cells lacked nuclear hyperchromasia or marked atypia, were S100-positive, and showed numerous mitochondria reactive with the anti-mitochondrial antibody. A diagnosis of lipoma-like hibernoma was made. Pathologists should be aware of this variant of hibernoma to avoid misdiagnosis and excessive treatment.     

海洛因戒断及复吸对大鼠肾上腺髓质细胞β-内啡肽和促肾上腺皮质激素表达及血清皮质醇的影响

目的 探讨海洛因戒断、脱毒及复吸对大鼠肾上腺髓质细胞β-内啡肽（β-EP）和促肾上腺皮质激素（ACTH）表达及血清皮质醇（COR）的影响。方法 成年雄性SD大鼠63只,随机分为实验组（21只）、盐水对照组（21只）和正常对照组（21只）,实验组又分为戒断组、脱毒组和复吸组,采用免疫组织化学、图像分析法及放射免疫测定法进行研究。结果 与正常及盐水对照组比较,海洛因戒断组β-EP免疫反应（β-EP-IR）细胞染色变浅,平均灰度值升高（P <0.05）;经美沙酮脱毒治疗,β-EP-IR细胞染色较正常及盐水对照组加深,平均灰度值降低（ P <0.05）;海洛因复吸组β-EP-IR细胞表达再次减弱,但与正常及盐水组比较,平均灰度值差异无显著性。与正常及盐水对照组比较,实验各组大鼠肾上腺髓质ACTH免疫反应（ACTH-IR）细胞染色均变浅,平均灰度值增高,有显著差异（P <0.05）。放射免疫测定结果表明,实验各组大鼠血清COR均显著高于正常对照组（P <0.05）。结论 海洛因戒断、脱毒、复吸影响了大鼠肾上腺髓质细胞表达β-EP、ACTH以及血清COR的分泌。     

MSCT对肾上腺不典型嗜铬细胞瘤与皮质癌的鉴别诊断价值

目的分析肾上腺不典型嗜铬细胞瘤与皮质癌的MSCT表现,寻找两者在MSCT方面有意义的鉴别点,提高诊断能力。方法回顾性分析经过手术后病理证实,具有完整MSCT检查及术后病理资料的不典型肾上腺嗜铬细胞瘤19例,肾上腺皮质癌13例,探讨两者鉴别点。结果不典型PHEO表面多呈浅分叶状,ACC则呈不规则深分叶为主。不典型PHEO边缘多清楚,ACC病灶长径5cm时边缘多清楚,长径5cm时边缘模糊。ACC出现出血、钙化、囊变坏死的可能性高于不典型PHEO。ACC以中央钙化及中央星形坏死囊变为主,不典型PHEO以边缘钙化及病灶边缘不规则坏死囊变为主。动态增强扫描不典型PHEO呈动脉期明显强化,ACC则呈轻-中度强化。ACC有实性部分丝络样强化、坏死区壁结节强化等特征形态。不典型PHEO可呈环状强化与ACC鉴别,但不具特征。结论 MSCT对肾上腺不典型嗜铬细胞瘤与皮质癌鉴别诊断有一定程度的价值。     

MSCT对健康成人肾上腺体积的测量研究

目的探讨MSCT对健康成人肾上腺体积的测量研究。方法选取2013年1月~2014年6月190例健康体检者作为研究对象,采用多层螺旋CT行增强扫描测量肾上腺体积的大小,着重观察健康成人双侧肾上腺的检出率及其与性别、年龄、体重、身高、血压等参数的关系。结果健康成人双侧肾上腺检出率为100%,左侧平均体积为(2803.18±869.74)mm3,明显大于右侧的(2010.82±726.33)mm3,比较差异有统计学意义(P0.05);男性肾上腺总体积、左侧平均体积、右侧平均体积分别为(5436.91±1576.07)mm3、(3021.48±930.45)mm3、(2448.07±764.95)mm3,均明显大于女性的,(4260.83±1510.34)mm3、(2589.85±880.61)mm3、(1634.90±796.38)mm3,差异有统计学意义(P0.05);双侧肾上腺体积56岁后缩小;肾上腺体积与体重呈正相关,与身高、血压无明显相关性。结论 MSCT可简便、准确测量肾上腺体积,是测量肾上腺的有效方法,为肾上腺病变的影像学诊断提供可靠依据,值得临床推广使用。     

Adrenal cortical carcinoma initially presented with overwhelming disseminated intravascular coagulation

We report a 54-year-old man who had adrenal cortical carcinoma initially manifested as features of overwhelming disseminated intravascular coagulation (DIC). In the initial diagnostic work-up, an adrenal mass was detected with venous thrombi in the abdominal imaging study, but the radiologic diagnosis was a hematoma arising from the adrenal gland and a biopsy was not possible due to a bleeding tendency. A lot of platelets and plasma products were transfused, but the bleeding tendency and other DIC features persisted. Finally, he expired because of newly developed massive pulmonary thromboembolism. To our knowledge, this is the first reported case of adrenal cortical carcinoma complicated with bleeding tendency caused by DIC as an initial manifestation. This suggests that adrenal cortical carcinoma should be considered in a patient with an adrenal mass and DIC features.     

糖皮质激素对大鼠肾上腺嗜铬细胞分泌儿茶酚胺的急性效应

利用全细胞膜片钳技术,观察不同浓度地塞米松急性灌洗大鼠肾上腺嗜铬细胞(AMCC)后钙通道电流和烟碱受体通道电流(INIC)的变化,地塞米松对大鼠AMCC的急性作用为明显抑制INIC而对电刺激所诱发的钙通道电流无明显影响,提示糖皮质激素对大鼠AMCC分泌儿茶酚胺的急性效应可能与烟碱受体直接相关。     

The development of the adrenal gland zona glomerulosa in the rat. A morphological, immunohistochemical and biochemical study

We have studied the development of the adrenal gland in the rat comprising the ages ranging from 0 to 90 days after birth. The weight of the animals and that of the adrenal glands demonstrated a linear growth with time until 75 days, both in males and females. The area of the zona glomerulosa (ZG) increased in size from birth until ≈40 days of age. After that, growth had a much smaller slope (females, r=0.84, P<0.001; males, r=0.81, P<0.001). Aldosterone secretion had a marked increase until 20 days of age and thereafter demonstrated a tendency for a decrease (females, r=−0.19, P<0.02; males r=−0.26, P<0.001). Plasma renin activity followed a trend parallel to that of aldosterone. The steroid precursor 18-OH-deoxycorticosterone (18-OH-DOC) demonstrated a different course as it increased progressively with age especially in the females (females, r=0.57, P<0.001; males, r=0.40, P<0.001). The expression of the enzyme 3-β-hydroxysteroid dehydrogenase (3-β-HSD) was also studied by immunohistochemistry and it was shown to be very low at birth and starting to increase by 10 days of age. After 30/40 days of age the amount of this enzyme existing in the ZG was comparable with that of the outer zona fasciculata (ZF). We conclude that the development of the ZG in the rat has particularities that make it different from that of the rest of the cortex.