1/332. thyroid gland papillary carcinoma with fibromatosis-like stroma: case report.Papillary carcinoma of the thyroid may show a variable degree of fibrosis of the stroma, but proliferation of the stromal fibroblasts mimicking fibromatosis is rare. There appears to be a new variant of papillary carcinoma of the thyroid associated with exuberant proliferation of the fibroblasts resembling fibromatosis. We present one such case in a 50 year old woman and succinctly reviewed the relevant literature of this rare variant. The necessity of a diligent search for a papillary carcinoma in thyroid gland which shows a proliferative fibrous lesion is stressed.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/332. Adenomyomatous hyperplasia of the papilla of Vater: A sequela of chronic papillitis?A case of adenomyomatous hyperplasia of the papilla of Vater is described. The lesion presented as a small polypoid tumor projecting into the duodenal lumen, causing obstruction and dilatation of the common bile duct. Serial cross-section of the ampulla showed diffuse thickening of the muscular layer corresponding to Oddi's sphincter, with resulting narrowing of the lumen. Many ductal or glandular components were dispersed within the mucosa and the muscular layer and were admixed with lymphocytes, a few lymphoid aggregates, and fibrosis. Based both on the absence of cellular atypia and the presence of inflammation, fibrosis, and preservation of the normal architecture of the ampulla, we favor the interpretation that this hyperplastic lesion represents a sequela of chronic papillitis. The different diagnoses for this lesion are presented along with a review of the literature.- - - - - - - - - - ranking = 0.2keywords = gland (Clic here for more details about this article) |
3/332. Benign lymphoepithelial lesion of the parotid gland with sebaceous differentiation.The salivary duct system in the setting of chronic sialadenitis is predisposed to undergo a variety of cellular modifications. This report documents a rare type of metaplasia of a parotid benign lymphoepithelial lesion. Epimyoepithelial islands showing focal sebaceous differentiation and pure sebaceous cell nests in addition to their usual histologic appearance were noted throughout the lesion. The possible pathogenesis is discussed through a review of the literature.- - - - - - - - - - ranking = 0.8keywords = gland (Clic here for more details about this article) |
4/332. Confocal imaging of sebaceous gland hyperplasia in vivo to assess efficacy and mechanism of pulsed dye laser treatment.BACKGROUND AND OBJECTIVE: This case demonstrates, for the first time, the use of in vivo confocal imaging to assess the efficacy of laser treatment of a skin lesion with a vascular component. STUDY DESIGN/PATIENT AND METHOD: A patient with lesions of sebaceous gland hyperplasia was histologically imaged in vivo before and after treatment with a 585 nm pulse dye laser (PDL) by using a near-infrared, confocal reflectance microscope. Hyperplastic sebaceous ducts and sebaceous glands were seen with high resolution in vivo. Prominent dermal vasculature was viewed as well as its selective targeting by PDL. CONCLUSION: Our results confirm the previously reported successful treatment of sebaceous gland hyperplasia with the 585 nm PDL.- - - - - - - - - - ranking = 1.4keywords = gland (Clic here for more details about this article) |
5/332. A case of extraadrenal pheochromocytoma associated with adrenal cortical nodular hyperplasia and papillary thyroid carcinoma.A 64-year-old woman was admitted in November, 1996 for fluctuating blood pressure. There was multinodular goiter in her neck. High urine VMA and serum aldosterone were noted. Computed tomography showed an oval lesion in the left adrenal gland. Left adrenalectomy was performed and the pathology was proved to be adrenal cortical nodular hyperplasia. Fluctuating blood pressure and high urine VMA persisted after the operation. CT scan of the abdomen revealed a soft tissue mass in lower abdomen. The patient was admitted again in September, 1997. Laboratory examinations showed normal serum aldosterone, normal plasma renin activity and high urine VMA. Aspiration cytology of the thyroid gland disclosed papillary thyroid carcinoma. [131I]-metaiodobenzylguanidine image revealed a high uptake lesion in the right L-3 paravertebral area. Tumor excision and thyroidectomy were performed. The pathology was reported as extraadrenal pheochromocytoma and papillary thyroid carcinoma. Papillary thyroid carcinoma is rarely associated with pheochromocytoma. To our knowledge, this paper is the first report of a patient with extraadrenal pheochromocytoma associated with papillary thyroid carcinoma and adrenal cortical nodular hyperplasia.- - - - - - - - - - ranking = 0.4keywords = gland (Clic here for more details about this article) |
6/332. Giant insulinoma in a patient with multiple endocrine neoplasia-type I: a case report.We report a case of giant cystic insulinoma constituting part of multiple endocrine neoplasia (MEN) type I. A 29-year-old Japanese man presented with a history of recurrent hypoglycemic attacks. Endocrine examination showed hyperinsulinemia discordant with hypoglycemia, and a giant cystic insulinoma (11 x 10 cm) located in the pancreatic tail was detected radiologically. hyperprolactinemia due to pituitary adenoma and hyperparathyroidism due to parathyroid hyperplasia were also present. The insulinoma, prolactinoma and hyperplastic parathyroid gland were surgically removed. Fluorescent microsatellite analysis detected loss of heterozygosity (LOH) in chromosome 11q13 in dna samples from all resected tissues but not from white blood cells. This is a rare case of MEN type I because of the giant cystic insulinoma and the evidence of common LOH detected in all MEN type I tissues.- - - - - - - - - - ranking = 0.2keywords = gland (Clic here for more details about this article) |
7/332. Unilateral macronodular adrenal hyperplasia as an unusual cause of Cushing's syndrome--a case study.To appraise clinicians of the problems that may be encountered in the diagnosis and management of Cushing's syndrome, we present a case report of a 20-year old female, who was admitted with a recently developed central obesity, ammenorrhea hirsuitism, proximal myopathy and depression. She was found to have multiple striae, thin skin, elevated blood pressure glycosuria and hyperglycaemia. Morning and mid-night plasma cortisol concentrations revealed elevated levels, with a loss of diurnal variation. There was a failure of the normal suppressibility of cortisol secretion by low doses of dexamethasone, while a significant suppression of plasma cortisol concentration was observed with high doses of dexamethasone. There were no significant abnormalities observed in the pituitary fossa on skull radiograph and on the cranial computerised tomographic scan. After a period of stabilisation, she had a bilateral adrenalectomy done, with a histopathological finding of a left adrenal macronodular hyperplasia, while the right adrenal gland was small and friable. There was an uneventful post-operative period, with a gradual return to normality of most of the presenting complaints. The hyperglycaemia and hypertension got controlled without medications, while her menstrual cycles resumed within three months of bilateral adrenalectomy. This case report illustrates that an adrenal-dependent Cushing's syndrome may mimic a pituitary-dependent one, especially as regards the suppressibility of plasma cortisol secretion by high doses of dexamethasone.- - - - - - - - - - ranking = 0.2keywords = gland (Clic here for more details about this article) |
8/332. food-dependent Cushing's syndrome: possible involvement of leptin in cortisol hypersecretion.Stimulation ofcortisol secretion by food intake has been implicated in the pathogenesis of some cases of ACTH-independent Cushing's syndrome, via an aberrant response of the adrenal glands to gastric inhibitory polypeptide (GIP). We report here a novel case of food-dependent Cushing's syndrome in a patient with bilateral macronodular adrenal hyperplasia. In this patient we were able to confirm a paradoxical stimulation of cortisol secretion by GIP in vivo as well as in vitro on dispersed tumor adrenal cells obtained at surgery. In addition to GIP, in vitro stimulation of these cultured tumor adrenal cells with leptin, the secreted product of the adipocyte, induced cortisol secretion. By comparison, no such stimulation was observed in vitro in adrenal cells obtained from another patient with bilateral macronodular adrenal hyperplasia and Cushing's syndrome that did not depend on food intake, in tumor cells obtained from a solitary cortisol-secreting adrenal adenoma, and in normal human adrenocortical cells. These results demonstrate that as in previously described cases of food-dependent Cushing's syndrome, GIP stimulated cortisol secretion from the adrenals of the patient reported here. Therefore, they indicate that such a paradoxical response probably represents the hallmark of this rare condition. In addition, they suggest that leptin, which normally inhibits stimulated cortisol secretion in humans, participated in cortisol hypersecretion in this case. Further studies in other cases of food-dependent Cushing's syndrome, however, will be necessary to better ascertain the pathophysiological significance of this finding.- - - - - - - - - - ranking = 0.2keywords = gland (Clic here for more details about this article) |
9/332. Familial nevoid sebaceous gland hyperplasia affecting three generations of a family.Familial sebaceous gland hyperplasia is a benign entity with onset at puberty and a tendency to worsen with age. It is characterized by a nevoid symmetric pattern in the sebaceous areas of the face sparing the orbital, perinasal, preauricular and perioral areas showing prominent follicular openings and interfollicular dermal yellowish or white prominent skin. Usually, the face is affected, with the neck, column and thorax affected in a milder pattern. We describe a family with familial nevoid sebaceous gland hyperplasia in three consecutive generations. All the patients were successfully treated with oral isotretinoin. The pedigree suggests autosomal dominant inheritance with incomplete penetrance.- - - - - - - - - - ranking = 1.2keywords = gland (Clic here for more details about this article) |
10/332. Multifocal oncocytic adenomatous hyperplasia of the parotid gland. A case report.A case report of a multifocal oncocytic adenomatous hyperplasia occurring in a parotid gland is presented. The differential diagnosis of (multicystic) Warthin's tumor is discussed.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
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