Adrenocortical Adenoma
Adrenocortical Carcinoma
Cushing Syndrome
Adrenal Cortex
17-Hydroxycorticosteroids
Hyperaldosteronism
Hydrocortisone
Adrenocorticotropic Hormone
Adrenal Glands
Adrenal Cortex Function Tests
Progesterone Reductase
Steroid 17-alpha-Hydroxylase
Aldosterone
Incidental Findings
Mitotane
Pheochromocytoma
Adrenocortical Hyperfunction
Immunohistochemistry
Adenoma, Pleomorphic
Adenoma, Villous
Tomography, X-Ray Computed
Pituitary Neoplasms
Steroid 11-beta-Hydroxylase
Cosyntropin
Zona Fasciculata
Adrenal Insufficiency
Myelolipoma
Lipoma
Vanilmandelic Acid
Lipomatosis
Microscopy
Primary aldosteronism with aldosterone-producing adrenal adenoma in a pregnant woman. (1/137)
A 30-year-old pregnant woman complained of muscle weakness at 29 weeks' gestation. She was hypertensive with severe hypokalemia. Lower plasma renin activity and higher aldosterone level than the normal values in pregnancy suggested primary aldosteronism. A cesarean delivery was performed at 31 weeks' gestation because of pulmonary congestion. The neonatal course was uncomplicated. The laparoscopic adrenalectomy for a 2.0-cm right adrenal adenoma resulted in normalizing of her blood pressure and serum potassium level. Although primary aldosteronism is rare, especially during pregnancy, it should be always considered as one of etiologies of hypertension in pregnancy. (+info)The expression of inhibin/activin subunits in the human adrenal cortex and its tumours. (2/137)
Inhibins and activins are dimeric proteins of the transforming growth factor-beta superfamily which have been shown to be expressed in the adrenal cortex. Recent studies have suggested a role for these peptides in the pathogenesis and/or function of adrenal tumours. To investigate further their physiological and pathological roles, we have documented immunoreactivity for inhibin alpha, betaA and betaB subunits in normal adult and fetal human adrenals, in hyperplastic adrenals and in adrenal tumours. In the normal and hyperplastic adult gland, diffuse immunopositivity was demonstrated for beta subunits, suggesting that activins (beta beta dimers) can be expressed in all zones. Inhibin alpha was limited to the zona reticularis and the innermost zona fasciculata in the normal gland, extending centripetally into the zona fasciculata in hyperplasia, supporting a role for ACTH in the regulation of expression, and suggesting that expression of inhibins (alpha beta dimers) is restricted. Immunopositivity for all three subunits was seen in both fetal and definitive zones of the fetal cortex, indicating that both inhibins and activins could be expressed in both. Immunopositivity for all three subunits was seen in most adrenocortical tumours. Loss of immunopositivity for inhibin alpha in a subgroup of carcinomas might indicate a role in tumour progression. The greater intensity of staining for inhibin alpha in tumours associated with Cushing's syndrome again suggests a link with cortisol production. (+info)Analysis of genomic alterations in sporadic adrenocortical lesions. Gain of chromosome 17 is an early event in adrenocortical tumorigenesis. (3/137)
Genetic changes underlying the tumorigenesis of sporadic adrenocortical tumors are poorly characterized. To search for characteristic genomic imbalances involved in adrenocortical tumors, we examined 41 adrenocortical lesions (12 carcinomas, 23 adenomas, and 6 hyperplasias) by comparative genomic hybridization. Our results show that genetic alterations are more frequent in malignant than in benign lesions and that they rarely occur in hyperplastic lesions. The most frequent DNA copy number changes in adrenocortical carcinomas included losses of 1p21-31, 2q, 3p, 3q, 6q, 9p, and 11q14-qter, as well as gains and amplifications of 5q12, 9q32-qter, 12q, and 20q. The genomic aberrations prevalently occurring in adrenocortical adenomas were gains of 17q, 17p, and 9q32-qter. Gains found in 2 of 6 adrenocortical hyperplastic lesions involved chromosome 17 or 17q only. These data indicate that oncogenes determining the early tumorigenesis of adrenocortical tumors may exist on chromosome 17 and that the number of genomic alterations is closely associated with tumor behavior in adrenocortical tumors. (+info)Recurrence of adrenal aldosterone-producing adenoma. (4/137)
Conn's syndrome (adrenal aldosterone-producing adenoma) and bilateral adrenal hyperplasia are the most common causes of primary aldosteronism. The treatment of choice for patients with aldosterone-producing adenoma is unilateral total adrenalectomy. Recurrence after adequate surgery is exceptional. We present a patient with recurrence of an aldosterone-producing adenoma in the right adrenal gland 9 years after adenomectomy of a aldosterone-producing adenoma in the same adrenal gland. We conclude that adenomectomy is not an adequate therapy for patients with adrenal aldosterone-producing adenoma. (+info)PET imaging of adrenal cortical tumors with the 11beta-hydroxylase tracer 11C-metomidate. (5/137)
The purpose of the study was to evaluate PET with the tracer 11C-metomidate as a method to identify adrenal cortical lesions. METHODS: PET with 11C-metomidate was performed in 15 patients with unilateral adrenal mass confirmed by CT. All patients subsequently underwent surgery, except 2 who underwent biopsy only. The lesions were histopathologically examined and diagnosed as adrenal cortical adenoma (n = 6; 3 nonfunctioning), adrenocortical carcinoma (n = 2), and nodular hyperplasia (n = 1). The remaining were noncortical lesions, including 1 pheochromocytoma, 1 myelolipoma, 2 adrenal cysts, and 2 metastases. RESULTS: All cortical lesions were easily identified because of exceedingly high uptake of 11C-metomidate, whereas the noncortical lesions showed very low uptake. High uptake was also seen in normal adrenal glands and in the stomach. The uptake was intermediate in the liver and low in other abdominal organs. Images obtained immediately after tracer injection displayed high uptake in the renal cortex and spleen. The tracer uptake in the cortical lesions increased throughout the examination. For quantitative evaluation of tracer binding in individual lesions, a model with the splenic radioactivity concentration assigned to represent nonspecific uptake was applied. Values derived with this method, however, did show the same specificity as the simpler standardized uptake value concept, with similar difference observed for cortical versus noncortical lesions. CONCLUSION: PET with 11C-metomidate has the potential to be an attractive method for the characterization of adrenal masses with the ability to discriminate lesions of adrenal cortical origin from noncortical lesions. (+info)Expression of inhibin alpha in adrenocortical tumours reflects the hormonal status of the neoplasm. (6/137)
Inhibins are gonadal glycoprotein hormones whose main endocrine function is to inhibit pituitary FSH secretion. In addition to testes and ovaries, other steroid-producing organs are sites of inhibin alpha subunit expression. To study the role of inhibins in human adrenal gland, we screened a panel of 150 adrenals (10 normal adrenals, 25 adrenocortical hyperplasias, 65 adrenocortical adenomas, 30 adrenocortical carcinomas and 20 phaeochromocytomas) for inhibin alpha expression. mRNA levels of inhibin alpha subunit were studied in 57 samples and all tissues were stained immunohistochemically with an inhibin alpha subunit-specific antibody. Inhibin alpha mRNA was detected in all adrenocortical tissues. Virilizing adenomas possessed a 10-fold higher median inhibin alpha mRNA expression than did normal adrenals. Bilaterally and nodularly hyperplastic adrenals and other than virilizing adrenocortical tumours had their median inhibin alpha mRNA levels close to those of normal adrenals. Immunohistochemically, inhibin alpha subunit was detectable in all normal and hyperplastic adrenals, as well as in 73% of the adrenocortical tumours. However, the percentage of inhibin alpha-positive cells varied greatly in different tumour types. The median percentage of positive cells was 10 in non-functional and Conn's adenomas, 30 in Cushing's adenomas and 75 in virilizing adenomas. In malignant adrenocortical tumours the median percentage of inhibin alpha-immunopositive cells was 20 in non-functional carcinomas, 30 in Conn's carcinomas, 65 in Cushing's carcinomas and 75 in virilizing carcinomas. All phaeochromocytomas were negative for inhibin alpha subunit both at the mRNA level and immunohistochemically. Our data show that inhibin alpha subunit is highly expressed in both normal and neoplastic androgen-producing adrenocortical cells, with less expression in cortisol-producing and hardly any in aldosterone-producing cells. This suggests a specific role for inhibins in the regulation of adrenal androgen production. We did not find any significant difference in inhibin alpha expression between benign and malignant adrenocortical tumours. Thus inhibin alpha gene does not seem to have a tumour suppressor role in human adrenal cortex. (+info)Molecular analysis of CDKN1C and TP53 in sporadic adrenal tumors. (7/137)
OBJECTIVE: To evaluate the roles of the CDKN1C (P57KIP2) gene, which encodes for the cyclin-dependent kinase inhibitor CDNC, and the TP53 tumor suppressor gene in adrenal tumorigenesis, as a means of investigating the molecular basis of sporadic adrenal tumors, which is unknown. DESIGN: Screening for the presence CDKN1C and TP53 mutations and analyzing the expression pattern of CDNC, P53 and its downstream effector CDN1 (P21WAF1/CIP1) in a series of 79 sporadic adrenal tumors. METHODS: Single-strand conformation polymorphism and sequencing were used for mutation analysis of CDKN1C and TP53 in blood and adrenal tissue samples. In a subgroup of 48 tissues, CDKN1C expression was evaluated by RT-PCR and immunohistochemistry. Immunohistochemical analysis of P53 and CDN1 was performed. RESULTS: No somatic mutations of CDKN1C were found in the tumors analyzed, in spite of low/absent CDNC expression in adrenocortical adenomas and carcinomas. Mutations in the TP53 gene were present in 70% of adrenocortical carcinomas, associated with abnormal P53 and CDN1 expression, but not in benign neoplasms. In the normal adrenal cortex, CDNC expression was strictly nuclear and confined to the cortical zone (i.e. zona glomerulosa and reticularis), with no staining in the medulla. CONCLUSIONS: Mutations in the TP53 gene are frequent in adrenocortical carcinomas and might be used as a marker of malignancy. In the normal adrenal cortex, the zone-specific pattern of expression of CDNC suggests a role in adrenal differentiation. (+info)Localization of the endothelin system in aldosterone-producing adenomas. (8/137)
Endothelin-1 (ET-1) could play a role in the regulation of aldosterone secretion of the human adrenal gland. The presence of the endothelin-converting enzyme 1 (ECE-1) and ET-1 suggests that there is a local ET system in the adrenal cortex, but the in situ synthesis of ET-1 remains to be confirmed. The cellular distribution of the whole ET system was evaluated in 20 cases of aldosterone-producing adenomas. Polymerase chain reaction studies gave strong signals for ECE-1 mRNA and the mRNAs for endothelin type A (ET(A)) and B (ET(B)) receptors and faint signals for prepro-ET-1 mRNA. In situ hybridization showed ET(A) receptors scattered throughout the adenoma, in both secretory cells and vascular structures (score, +). There were more ET(B) receptors (score, ++), but they were restricted mainly to the endothelium. ECE-1 mRNA and protein were ubiquitous and abundant in secretory cells (score, +++) and vascular structures (score, ++); the enzyme was active on big ET-1. There was no prepro-ET-1 mRNA in the cortex, except in the thickened precapillary arterioles present in only 30% of the aldosterone-producing adenomas studied. ET-1 immunoreactivity was detected in vascular structures (score, +), probably bound to receptors, suggesting that ET-1 has an endocrine action. The low concentrations of ET-1 could also indicate that it acts in a paracrine-autocrine fashion to control adrenal blood flow. The discrepancy between the concentrations of ECE-1 and its substrate suggests that ECE-1 has another role in the adrenal secretory cells. Our data indicate that ET probably is not a primary cause of the development or maintenance of the adenoma. (+info)An adrenocortical adenoma is a benign tumor that arises from the cells of the adrenal cortex, which is the outer layer of the adrenal gland. These tumors can produce and release various hormones, such as cortisol, aldosterone, or androgens, depending on the type of cells they originate from.
Most adrenocortical adenomas are nonfunctioning, meaning that they do not secrete excess hormones and may not cause any symptoms. However, some functioning adenomas can produce excessive amounts of hormones, leading to a variety of clinical manifestations. For example:
* Cortisol-secreting adenomas can result in Cushing's syndrome, characterized by weight gain, muscle wasting, thin skin, easy bruising, and mood changes.
* Aldosterone-producing adenomas can cause Conn's syndrome, marked by hypertension (high blood pressure), hypokalemia (low potassium levels), and metabolic alkalosis.
* Androgen-secreting adenomas may lead to hirsutism (excessive hair growth) or virilization (development of male secondary sexual characteristics) in women.
The diagnosis of an adrenocortical adenoma typically involves imaging tests, such as CT or MRI scans, and hormonal evaluations to determine if the tumor is functioning or not. Treatment usually consists of surgical removal of the tumor, especially if it is causing hormonal imbalances or growing in size.
Adrenal cortex neoplasms refer to abnormal growths (tumors) in the adrenal gland's outer layer, known as the adrenal cortex. These neoplasms can be benign or malignant (cancerous). Benign tumors are called adrenal adenomas, while cancerous tumors are called adrenocortical carcinomas.
Adrenal cortex neoplasms can produce various hormones, leading to different clinical presentations. For instance, they may cause Cushing's syndrome (characterized by excessive cortisol production), Conn's syndrome (caused by aldosterone excess), or virilization (due to androgen excess). Some tumors may not produce any hormones and are discovered incidentally during imaging studies for unrelated conditions.
The diagnosis of adrenal cortex neoplasms typically involves a combination of imaging techniques, such as CT or MRI scans, and hormonal assessments to determine if the tumor is functional or non-functional. In some cases, a biopsy may be necessary to confirm the diagnosis and differentiate between benign and malignant tumors. Treatment options depend on the type, size, location, and hormonal activity of the neoplasm and may include surgical excision, radiation therapy, chemotherapy, or a combination of these approaches.
An adenoma is a benign (noncancerous) tumor that develops from glandular epithelial cells. These types of cells are responsible for producing and releasing fluids, such as hormones or digestive enzymes, into the surrounding tissues. Adenomas can occur in various organs and glands throughout the body, including the thyroid, pituitary, adrenal, and digestive systems.
Depending on their location, adenomas may cause different symptoms or remain asymptomatic. Some common examples of adenomas include:
1. Colorectal adenoma (also known as a polyp): These growths occur in the lining of the colon or rectum and can develop into colorectal cancer if left untreated. Regular screenings, such as colonoscopies, are essential for early detection and removal of these polyps.
2. Thyroid adenoma: This type of adenoma affects the thyroid gland and may result in an overproduction or underproduction of hormones, leading to conditions like hyperthyroidism (overactive thyroid) or hypothyroidism (underactive thyroid).
3. Pituitary adenoma: These growths occur in the pituitary gland, which is located at the base of the brain and controls various hormonal functions. Depending on their size and location, pituitary adenomas can cause vision problems, headaches, or hormonal imbalances that affect growth, reproduction, and metabolism.
4. Liver adenoma: These rare benign tumors develop in the liver and may not cause any symptoms unless they become large enough to press on surrounding organs or structures. In some cases, liver adenomas can rupture and cause internal bleeding.
5. Adrenal adenoma: These growths occur in the adrenal glands, which are located above the kidneys and produce hormones that regulate stress responses, metabolism, and blood pressure. Most adrenal adenomas are nonfunctioning, meaning they do not secrete excess hormones. However, functioning adrenal adenomas can lead to conditions like Cushing's syndrome or Conn's syndrome, depending on the type of hormone being overproduced.
It is essential to monitor and manage benign tumors like adenomas to prevent potential complications, such as rupture, bleeding, or hormonal imbalances. Treatment options may include surveillance with imaging studies, medication to manage hormonal issues, or surgical removal of the tumor in certain cases.
Adrenocortical carcinoma (ACC) is a rare cancer that develops in the outer layer of the adrenal gland, known as the adrenal cortex. The adrenal glands are small hormone-producing glands located on top of each kidney. They produce important hormones such as cortisol, aldosterone, and sex steroids.
ACC is a malignant tumor that can invade surrounding tissues and organs and may metastasize (spread) to distant parts of the body. Symptoms of ACC depend on the size and location of the tumor and whether it produces excess hormones. Common symptoms include abdominal pain, a mass in the abdomen, weight loss, and weakness. Excessive production of hormones can lead to additional symptoms such as high blood pressure, Cushing's syndrome, virilization (excessive masculinization), or feminization.
The exact cause of ACC is not known, but genetic factors, exposure to certain chemicals, and radiation therapy may increase the risk of developing this cancer. Treatment options for ACC include surgery, chemotherapy, radiation therapy, and targeted therapy. The prognosis for ACC varies depending on the stage and extent of the disease at diagnosis, as well as the patient's overall health.
Cushing syndrome is a hormonal disorder that occurs when your body is exposed to high levels of the hormone cortisol for a long time. This can happen due to various reasons such as taking high doses of corticosteroid medications or tumors that produce cortisol or adrenocorticotropic hormone (ACTH).
The symptoms of Cushing syndrome may include:
* Obesity, particularly around the trunk and upper body
* Thinning of the skin, easy bruising, and purple or red stretch marks on the abdomen, thighs, breasts, and arms
* Weakened bones, leading to fractures
* High blood pressure
* High blood sugar
* Mental changes such as depression, anxiety, and irritability
* Increased fatigue and weakness
* Menstrual irregularities in women
* Decreased fertility in men
Cushing syndrome can be diagnosed through various tests, including urine and blood tests to measure cortisol levels, saliva tests, and imaging tests to locate any tumors. Treatment depends on the cause of the condition but may include surgery, radiation therapy, chemotherapy, or adjusting medication dosages.
The adrenal cortex is the outer portion of the adrenal gland, which is located on top of the kidneys. It plays a crucial role in producing hormones that are essential for various bodily functions. The adrenal cortex is divided into three zones:
1. Zona glomerulosa: This outermost zone produces mineralocorticoids, primarily aldosterone. Aldosterone helps regulate sodium and potassium balance and thus influences blood pressure by controlling the amount of fluid in the body.
2. Zona fasciculata: The middle layer is responsible for producing glucocorticoids, with cortisol being the most important one. Cortisol regulates metabolism, helps manage stress responses, and has anti-inflammatory properties. It also plays a role in blood sugar regulation and maintaining the body's response to injury and illness.
3. Zona reticularis: The innermost zone produces androgens, primarily dehydroepiandrosterone (DHEA) and its sulfate form (DHEAS). These androgens are weak compared to those produced by the gonads (ovaries or testes), but they can be converted into more potent androgens or estrogens in peripheral tissues.
Disorders related to the adrenal cortex can lead to hormonal imbalances, affecting various bodily functions. Examples include Addison's disease (insufficient adrenal cortical hormone production) and Cushing's syndrome (excessive glucocorticoid levels).
17-Hydroxycorticosteroids are a class of steroid hormones that are produced in the adrenal gland. They are formed from the metabolism of cortisol, which is a hormone that helps regulate metabolism, immune response, and stress response. 17-Hydroxycorticosteroids include compounds such as cortisone and corticosterone.
These hormones have various functions in the body, including:
* Regulation of carbohydrate, fat, and protein metabolism
* Suppression of the immune system
* Modulation of the stress response
* Influence on blood pressure and electrolyte balance
Abnormal levels of 17-hydroxycorticosteroids can indicate problems with the adrenal gland or pituitary gland, which regulates adrenal function. They are often measured in urine or blood tests to help diagnose conditions such as Cushing's syndrome (overproduction of cortisol) and Addison's disease (underproduction of cortisol).
Adrenal cortex diseases refer to a group of conditions that affect the adrenal glands, which are small glands located on top of the kidneys. The adrenal glands consist of two parts: the outer adrenal cortex and the inner medulla. The adrenal cortex is responsible for producing hormones such as cortisol, aldosterone, and androgens that regulate various bodily functions, including metabolism, blood pressure, and sexual development.
Diseases of the adrenal cortex can result from an overproduction or underproduction of these hormones. Some common adrenal cortex diseases include:
1. Addison's disease: a condition characterized by insufficient production of hormones by the adrenal glands, leading to symptoms such as fatigue, weight loss, low blood pressure, and darkening of the skin.
2. Cushing's syndrome: a condition caused by an excess of cortisol in the body, which can result from taking high doses of corticosteroid medications or from a tumor in the pituitary gland or adrenal glands. Symptoms include weight gain, particularly around the trunk and face, thinning of the skin, easy bruising, muscle weakness, and mood changes.
3. Congenital adrenal hyperplasia: a group of inherited disorders that affect the production of hormones by the adrenal glands. Depending on the specific type of congenital adrenal hyperplasia, symptoms can range from ambiguous genitalia in newborns to precocious puberty, short stature, and infertility in older children and adults.
4. Adrenal tumors: benign or cancerous growths that develop in the adrenal glands and can cause hormonal imbalances. Symptoms depend on the type of tumor and the hormones it produces.
Treatment for adrenal cortex diseases depends on the specific condition and its underlying cause. Treatment options may include medication, surgery, or radiation therapy.
Adrenalectomy is a surgical procedure in which one or both adrenal glands are removed. The adrenal glands are small, triangular-shaped glands located on top of each kidney that produce hormones such as cortisol, aldosterone, and adrenaline (epinephrine).
There are several reasons why an adrenalectomy may be necessary. For example, the procedure may be performed to treat tumors or growths on the adrenal glands, such as pheochromocytomas, which can cause high blood pressure and other symptoms. Adrenalectomy may also be recommended for patients with Cushing's syndrome, a condition in which the body is exposed to too much cortisol, or for those with adrenal cancer.
During an adrenalectomy, the surgeon makes an incision in the abdomen or back and removes the affected gland or glands. In some cases, laparoscopic surgery may be used, which involves making several small incisions and using specialized instruments to remove the gland. After the procedure, patients may need to take hormone replacement therapy to compensate for the loss of adrenal gland function.
Adrenal gland neoplasms refer to abnormal growths or tumors in the adrenal glands. These glands are located on top of each kidney and are responsible for producing hormones that regulate various bodily functions such as metabolism, blood pressure, and stress response. Adrenal gland neoplasms can be benign (non-cancerous) or malignant (cancerous).
Benign adrenal tumors are called adenomas and are usually small and asymptomatic. However, some adenomas may produce excessive amounts of hormones, leading to symptoms such as high blood pressure, weight gain, and mood changes.
Malignant adrenal tumors are called adrenocortical carcinomas and are rare but aggressive cancers that can spread to other parts of the body. Symptoms of adrenocortical carcinoma may include abdominal pain, weight loss, and hormonal imbalances.
It is important to diagnose and treat adrenal gland neoplasms early to prevent complications and improve outcomes. Diagnostic tests may include imaging studies such as CT scans or MRIs, as well as hormone level testing and biopsy. Treatment options may include surgery, radiation therapy, chemotherapy, or a combination of these approaches.
Hyperaldosteronism is a medical condition characterized by the overproduction of aldosterone, a hormone produced by the adrenal glands. Aldosterone helps regulate sodium and potassium balance and blood pressure by promoting sodium retention and potassium excretion in the kidneys.
There are two types of hyperaldosteronism: primary and secondary. Primary hyperaldosteronism is caused by an overproduction of aldosterone from an abnormality within the adrenal gland, such as a tumor (Conn's syndrome) or hyperplasia. Secondary hyperaldosteronism occurs when there is an excess production of renin, a hormone produced by the kidneys, which then stimulates the adrenal glands to produce more aldosterone. This can be caused by various conditions that affect kidney function, such as renal artery stenosis or heart failure.
Symptoms of hyperaldosteronism may include high blood pressure, low potassium levels (hypokalemia), muscle weakness, and frequent urination. Diagnosis typically involves measuring aldosterone and renin levels in the blood, as well as other tests to determine the underlying cause. Treatment depends on the type and cause of hyperaldosteronism but may include medications, surgery, or lifestyle changes.
Hydrocortisone is a synthetic glucocorticoid, which is a class of steroid hormones. It is identical to the naturally occurring cortisol, a hormone produced by the adrenal gland that helps regulate metabolism and helps your body respond to stress. Hydrocortisone has anti-inflammatory effects and is used to treat various inflammatory conditions such as allergies, skin disorders, and autoimmune diseases. It works by suppressing the immune system's response to reduce swelling, redness, itching, and other symptoms caused by inflammation.
Hydrocortisone is available in different forms, including oral tablets, topical creams, lotions, gels, and ointments, as well as injectable solutions. The specific use and dosage depend on the condition being treated and the individual patient's medical history and current health status.
As with any medication, hydrocortisone can have side effects, especially when used in high doses or for extended periods. Common side effects include increased appetite, weight gain, mood changes, insomnia, and skin thinning. Long-term use of hydrocortisone may also increase the risk of developing osteoporosis, diabetes, cataracts, and other health problems. Therefore, it is essential to follow your healthcare provider's instructions carefully when using this medication.
Adrenocorticotropic Hormone (ACTH) is a hormone produced and released by the anterior pituitary gland, a small endocrine gland located at the base of the brain. ACTH plays a crucial role in the regulation of the body's stress response and has significant effects on various physiological processes.
The primary function of ACTH is to stimulate the adrenal glands, which are triangular-shaped glands situated on top of the kidneys. The adrenal glands consist of two parts: the outer cortex and the inner medulla. ACTH specifically targets the adrenal cortex, where it binds to specific receptors and initiates a series of biochemical reactions leading to the production and release of steroid hormones, primarily cortisol (a glucocorticoid) and aldosterone (a mineralocorticoid).
Cortisol is involved in various metabolic processes, such as regulating blood sugar levels, modulating the immune response, and helping the body respond to stress. Aldosterone plays a vital role in maintaining electrolyte and fluid balance by promoting sodium reabsorption and potassium excretion in the kidneys.
ACTH release is controlled by the hypothalamus, another part of the brain, which produces corticotropin-releasing hormone (CRH). CRH stimulates the anterior pituitary gland to secrete ACTH, which in turn triggers cortisol production in the adrenal glands. This complex feedback system helps maintain homeostasis and ensures that appropriate amounts of cortisol are released in response to various physiological and psychological stressors.
Disorders related to ACTH can lead to hormonal imbalances, resulting in conditions such as Cushing's syndrome (excessive cortisol production) or Addison's disease (insufficient cortisol production). Proper diagnosis and management of these disorders typically involve assessing the function of the hypothalamic-pituitary-adrenal axis and addressing any underlying issues affecting ACTH secretion.
The adrenal glands are a pair of endocrine glands that are located on top of the kidneys. Each gland has two parts: the outer cortex and the inner medulla. The adrenal cortex produces hormones such as cortisol, aldosterone, and androgens, which regulate metabolism, blood pressure, and other vital functions. The adrenal medulla produces catecholamines, including epinephrine (adrenaline) and norepinephrine (noradrenaline), which help the body respond to stress by increasing heart rate, blood pressure, and alertness.
Adrenal cortex function tests are a group of diagnostic tests that evaluate the proper functioning of the adrenal cortex, which is the outer layer of the adrenal glands. These glands are located on top of each kidney and are responsible for producing several essential hormones. The adrenal cortex produces hormones such as cortisol, aldosterone, and androgens.
There are several types of adrenal cortex function tests, including:
1. Cortisol testing: This test measures the levels of cortisol in the blood or urine to determine if the adrenal glands are producing adequate amounts of this hormone. Cortisol helps regulate metabolism, immune response, and stress response.
2. ACTH (adrenocorticotropic hormone) stimulation test: This test measures the adrenal gland's response to ACTH, a hormone produced by the pituitary gland that stimulates the adrenal glands to produce cortisol. The test involves administering synthetic ACTH and measuring cortisol levels before and after administration.
3. Aldosterone testing: This test measures the levels of aldosterone in the blood or urine to determine if the adrenal glands are producing adequate amounts of this hormone. Aldosterone helps regulate electrolyte balance and blood pressure.
4. Dexamethasone suppression test: This test involves administering dexamethasone, a synthetic corticosteroid, to suppress cortisol production. The test measures cortisol levels before and after administration to determine if the adrenal glands are overproducing cortisol.
5. Androgen testing: This test measures the levels of androgens, such as testosterone and dehydroepiandrosterone (DHEA), in the blood or urine to determine if the adrenal glands are producing excessive amounts of these hormones.
Abnormal results from adrenal cortex function tests may indicate conditions such as Addison's disease, Cushing's syndrome, congenital adrenal hyperplasia, and pheochromocytoma.
Progesterone reductase is not a widely recognized or used term in medical literature. However, based on the terms "progesterone" and "reductase," it can be inferred that progesterone reductase might refer to an enzyme responsible for reducing or converting progesterone into another form through a reduction reaction.
Progesterone is a steroid hormone involved in the menstrual cycle, pregnancy, and embryogenesis. Reductases are enzymes that catalyze the transfer of electrons from a donor to an acceptor, often resulting in the reduction of a substrate. In this context, progesterone reductase could potentially refer to an enzyme responsible for reducing progesterone into a different steroid hormone or metabolite.
However, it is essential to note that there is no widely accepted or established definition of "progesterone reductase" in medical literature. If you are looking for information on a specific enzyme related to progesterone metabolism, I would recommend consulting primary scientific literature or seeking guidance from a medical professional.
Steroid 17-alpha-hydroxylase, also known as CYP17A1, is a cytochrome P450 enzyme that plays a crucial role in steroid hormone biosynthesis. It is located in the endoplasmic reticulum of cells in the adrenal glands and gonads. This enzyme catalyzes the 17-alpha-hydroxylation and subsequent lyase cleavage of pregnenolone and progesterone, converting them into dehydroepiandrosterone (DHEA) and androstenedione, respectively. These steroid intermediates are essential for the biosynthesis of both glucocorticoids and sex steroids, including cortisol, aldosterone, estrogens, and testosterone.
Defects in the CYP17A1 gene can lead to several disorders, such as congenital adrenal hyperplasia (CAH) due to 17-alpha-hydroxylase deficiency, which is characterized by decreased production of cortisol and sex steroids and increased mineralocorticoid levels. This condition results in sexual infantilism, electrolyte imbalances, and hypertension.
Aldosterone is a hormone produced by the adrenal gland. It plays a key role in regulating sodium and potassium balance and maintaining blood pressure through its effects on the kidneys. Aldosterone promotes the reabsorption of sodium ions and the excretion of potassium ions in the distal tubules and collecting ducts of the nephrons in the kidneys. This increases the osmotic pressure in the blood, which in turn leads to water retention and an increase in blood volume and blood pressure.
Aldosterone is released from the adrenal gland in response to a variety of stimuli, including angiotensin II (a peptide hormone produced as part of the renin-angiotensin-aldosterone system), potassium ions, and adrenocorticotropic hormone (ACTH) from the pituitary gland. The production of aldosterone is regulated by a negative feedback mechanism involving sodium levels in the blood. High sodium levels inhibit the release of aldosterone, while low sodium levels stimulate its release.
In addition to its role in maintaining fluid and electrolyte balance and blood pressure, aldosterone has been implicated in various pathological conditions, including hypertension, heart failure, and primary hyperaldosteronism (a condition characterized by excessive production of aldosterone).
Incidental findings are diagnoses or conditions that are discovered unintentionally while evaluating a patient for a different condition or symptom. These findings are not related to the primary reason for the medical examination, investigation, or procedure. They can occur in various contexts such as radiology studies, laboratory tests, or physical examinations.
Incidental findings can sometimes lead to further evaluation and management, depending on their nature and potential clinical significance. However, they also pose challenges related to communication, informed consent, and potential patient anxiety or harm. Therefore, it is essential to have clear guidelines for managing incidental findings in clinical practice.
Mitotane is not a general medical term, but it is a specific medication used in the treatment of certain types of cancer. Medically, Mitotane is known as an adrenal steroidogenesis inhibitor. It works by blocking the production of certain hormones in the adrenal glands, which can help to control the growth of some types of cancer cells.
Mitotane is primarily used in the treatment of advanced adrenocortical carcinoma (ACC), a rare type of cancer that develops in the outer layer of the adrenal gland. It may also be used in the management of other hormone-related cancers, such as certain types of thyroid or prostate cancer.
The medication is available in capsule form and is typically taken several times a day. Mitotane has a narrow therapeutic index, meaning that there is only a small range between an effective dose and a toxic one. Therefore, patients taking Mitotane require regular monitoring of their blood levels to ensure they remain within the safe range.
Common side effects associated with Mitotane include nausea, vomiting, diarrhea, dizziness, drowsiness, and changes in appetite or weight. More severe side effects may include neurological problems, such as confusion, disorientation, or memory loss, as well as an increased risk of infection due to its effect on the immune system.
Pheochromocytoma is a rare type of tumor that develops in the adrenal glands, which are triangular-shaped glands located on top of each kidney. These tumors produce excessive amounts of hormones called catecholamines, including adrenaline and noradrenaline. This can lead to a variety of symptoms such as high blood pressure, sweating, headaches, rapid heartbeat, and anxiety.
Pheochromocytomas are typically slow-growing and can be benign or malignant (cancerous). While the exact cause of these tumors is not always known, some genetic factors have been identified that may increase a person's risk. Treatment usually involves surgical removal of the tumor, along with medications to manage symptoms and control blood pressure before and after surgery.
Adrenocortical hyperfunction, also known as Cushing's syndrome, is a condition characterized by the overproduction of cortisol hormone from the adrenal glands. The adrenal glands are located on top of the kidneys and are responsible for producing several essential hormones, including cortisol. Cortisol helps regulate metabolism, blood pressure, and the body's response to stress.
In Adrenocortical hyperfunction, the adrenal glands produce too much cortisol, leading to a range of symptoms such as weight gain, particularly around the trunk and face, thinning of the skin, easy bruising, muscle weakness, mood changes, and high blood pressure. The condition can be caused by several factors, including tumors in the pituitary gland or adrenal glands, long-term use of corticosteroid medications, or genetic disorders that affect the adrenal glands.
Treatment for Adrenocortical hyperfunction depends on the underlying cause of the condition and may include surgery to remove tumors, medication to reduce cortisol production, or radiation therapy. It is essential to diagnose and treat this condition promptly, as long-term exposure to high levels of cortisol can lead to serious health complications such as diabetes, osteoporosis, and heart disease.
Immunohistochemistry (IHC) is a technique used in pathology and laboratory medicine to identify specific proteins or antigens in tissue sections. It combines the principles of immunology and histology to detect the presence and location of these target molecules within cells and tissues. This technique utilizes antibodies that are specific to the protein or antigen of interest, which are then tagged with a detection system such as a chromogen or fluorophore. The stained tissue sections can be examined under a microscope, allowing for the visualization and analysis of the distribution and expression patterns of the target molecule in the context of the tissue architecture. Immunohistochemistry is widely used in diagnostic pathology to help identify various diseases, including cancer, infectious diseases, and immune-mediated disorders.
Dexamethasone is a type of corticosteroid medication, which is a synthetic version of a natural hormone produced by the adrenal glands. It is often used to reduce inflammation and suppress the immune system in a variety of medical conditions, including allergies, asthma, rheumatoid arthritis, and certain skin conditions.
Dexamethasone works by binding to specific receptors in cells, which triggers a range of anti-inflammatory effects. These include reducing the production of chemicals that cause inflammation, suppressing the activity of immune cells, and stabilizing cell membranes.
In addition to its anti-inflammatory effects, dexamethasone can also be used to treat other medical conditions, such as certain types of cancer, brain swelling, and adrenal insufficiency. It is available in a variety of forms, including tablets, liquids, creams, and injectable solutions.
Like all medications, dexamethasone can have side effects, particularly if used for long periods of time or at high doses. These may include mood changes, increased appetite, weight gain, acne, thinning skin, easy bruising, and an increased risk of infections. It is important to follow the instructions of a healthcare provider when taking dexamethasone to minimize the risk of side effects.
A pleomorphic adenoma is a type of benign (non-cancerous) tumor that typically develops in the salivary glands, although they can also occur in other areas such as the nasopharynx and skin. "Pleomorphic" refers to the diverse appearance of the cells within the tumor, which can vary in size, shape, and arrangement.
Pleomorphic adenomas are composed of a mixture of epithelial and mesenchymal cells, which can form glandular structures, squamous (scale-like) cells, and areas that resemble cartilage or bone. These tumors tend to grow slowly and usually do not spread to other parts of the body.
While pleomorphic adenomas are generally not dangerous, they can cause problems if they become large enough to press on surrounding tissues or structures. In some cases, these tumors may also undergo malignant transformation, leading to a cancerous growth known as carcinoma ex pleomorphic adenoma. Surgical removal is the standard treatment for pleomorphic adenomas, and the prognosis is generally good with proper management.
A villous adenoma is a type of polyp (a growth that protrudes from the lining of an organ) found in the colon or rectum. It is named for its appearance under a microscope, which reveals finger-like projections called "villi" on the surface of the polyp.
Villous adenomas are typically larger than other types of polyps and can be several centimeters in size. They are also more likely to be cancerous or precancerous, meaning that they have the potential to develop into colon or rectal cancer over time.
Because of this increased risk, it is important for villous adenomas to be removed surgically if they are found during a colonoscopy or other diagnostic procedure. Regular follow-up colonoscopies may also be recommended to monitor for the development of new polyps or recurrence of previous ones.
X-ray computed tomography (CT or CAT scan) is a medical imaging method that uses computer-processed combinations of many X-ray images taken from different angles to produce cross-sectional (tomographic) images (virtual "slices") of the body. These cross-sectional images can then be used to display detailed internal views of organs, bones, and soft tissues in the body.
The term "computed tomography" is used instead of "CT scan" or "CAT scan" because the machines take a series of X-ray measurements from different angles around the body and then use a computer to process these data to create detailed images of internal structures within the body.
CT scanning is a noninvasive, painless medical test that helps physicians diagnose and treat medical conditions. CT imaging provides detailed information about many types of tissue including lung, bone, soft tissue and blood vessels. CT examinations can be performed on every part of the body for a variety of reasons including diagnosis, surgical planning, and monitoring of therapeutic responses.
In computed tomography (CT), an X-ray source and detector rotate around the patient, measuring the X-ray attenuation at many different angles. A computer uses this data to construct a cross-sectional image by the process of reconstruction. This technique is called "tomography". The term "computed" refers to the use of a computer to reconstruct the images.
CT has become an important tool in medical imaging and diagnosis, allowing radiologists and other physicians to view detailed internal images of the body. It can help identify many different medical conditions including cancer, heart disease, lung nodules, liver tumors, and internal injuries from trauma. CT is also commonly used for guiding biopsies and other minimally invasive procedures.
In summary, X-ray computed tomography (CT or CAT scan) is a medical imaging technique that uses computer-processed combinations of many X-ray images taken from different angles to produce cross-sectional images of the body. It provides detailed internal views of organs, bones, and soft tissues in the body, allowing physicians to diagnose and treat medical conditions.
Pituitary neoplasms refer to abnormal growths or tumors in the pituitary gland, a small endocrine gland located at the base of the brain. These neoplasms can be benign (non-cancerous) or malignant (cancerous), with most being benign. They can vary in size and may cause various symptoms depending on their location, size, and hormonal activity.
Pituitary neoplasms can produce and secrete excess hormones, leading to a variety of endocrine disorders such as Cushing's disease (caused by excessive ACTH production), acromegaly (caused by excessive GH production), or prolactinoma (caused by excessive PRL production). They can also cause local compression symptoms due to their size, leading to headaches, vision problems, and cranial nerve palsies.
The exact causes of pituitary neoplasms are not fully understood, but genetic factors, radiation exposure, and certain inherited conditions may increase the risk of developing these tumors. Treatment options for pituitary neoplasms include surgical removal, radiation therapy, and medical management with drugs that can help control hormonal imbalances.
A liver cell adenoma is a benign tumor that develops in the liver and is composed of cells similar to those normally found in the liver (hepatocytes). These tumors are usually solitary, but multiple adenomas can occur, especially in women who have taken oral contraceptives for many years. Liver cell adenomas are typically asymptomatic and are often discovered incidentally during imaging studies performed for other reasons. In rare cases, they may cause symptoms such as abdominal pain or discomfort, or complications such as bleeding or rupture. Treatment options include monitoring with periodic imaging studies or surgical removal of the tumor.
Steroid 11-beta-hydroxylase is a crucial enzyme involved in the steroidogenesis pathway, specifically in the synthesis of cortisol and aldosterone, which are vital hormones produced by the adrenal glands. This enzyme is encoded by the CYP11B1 gene in humans.
The enzyme's primary function is to catalyze the conversion of 11-deoxycortisol to cortisol and 11-deoxycorticosterone to aldosterone through the process of hydroxylation at the 11-beta position of the steroid molecule. Cortisol is a critical glucocorticoid hormone that helps regulate metabolism, immune response, and stress response, while aldosterone is a mineralocorticoid hormone responsible for maintaining electrolyte and fluid balance in the body.
Deficiencies or mutations in the CYP11B1 gene can lead to various disorders, such as congenital adrenal hyperplasia (CAH), which may result in impaired cortisol and aldosterone production, causing hormonal imbalances and associated symptoms.
Cosyntropin is a synthetic form of adrenocorticotropic hormone (ACTH) that is used in medical testing to assess the function of the adrenal glands. ACTH is a hormone produced and released by the pituitary gland that stimulates the production and release of cortisol, a steroid hormone produced by the adrenal glands.
Cosyntropin is typically administered as an injection, and its effects on cortisol production are measured through blood tests taken at various time points after administration. This test, known as a cosyntropin stimulation test or ACTH stimulation test, can help diagnose conditions that affect the adrenal glands, such as Addison's disease or adrenal insufficiency.
It is important to note that while cosyntropin is a synthetic form of ACTH, it is not identical to the natural hormone and may have slightly different effects on the body. Therefore, it should only be used under the supervision of a healthcare professional.
The Zona Fasciculata is a region within the adrenal gland, which is a small gland located on top of the kidneys. It plays an essential role in endocrine function. The adrenal gland is divided into two main parts: the outer cortex and the inner medulla. The cortex itself is further divided into three zones: the Zona Glomerulosa, the Zona Fasciculata, and the Zona Reticularis.
The Zona Fasciculata is the middle layer of the adrenal cortex. It is primarily responsible for producing and releasing steroid hormones, particularly glucocorticoids such as cortisol. Cortisol helps regulate metabolism, immune response, and stress response, among other functions. The Zona Fasciculata contains large, column-shaped cells called fasciculated cells that contain lipid droplets filled with cholesterol esters. These cells convert cholesterol into pregnenolone, which is then converted into cortisol through a series of enzymatic reactions.
In summary, the Zona Fasciculata is a crucial region within the adrenal gland that produces and releases cortisol, a vital glucocorticoid hormone involved in various physiological processes.
Adrenal insufficiency is a condition in which the adrenal glands do not produce adequate amounts of certain hormones, primarily cortisol and aldosterone. Cortisol helps regulate metabolism, respond to stress, and suppress inflammation, while aldosterone helps regulate sodium and potassium levels in the body to maintain blood pressure.
Primary adrenal insufficiency, also known as Addison's disease, occurs when there is damage to the adrenal glands themselves, often due to autoimmune disorders, infections, or certain medications. Secondary adrenal insufficiency occurs when the pituitary gland fails to produce enough adrenocorticotropic hormone (ACTH), which stimulates the adrenal glands to produce cortisol.
Symptoms of adrenal insufficiency may include fatigue, weakness, weight loss, decreased appetite, nausea, vomiting, diarrhea, abdominal pain, low blood pressure, dizziness, and darkening of the skin. Treatment typically involves replacing the missing hormones with medications taken orally or by injection.
Myelolipoma is a type of benign tumor that occurs in the adrenal gland, which is located on top of each kidney. This tumor is composed of both fatty tissue (lipoma) and cells that are similar to those found in the bone marrow (myeloid). Myelolipomas are usually small and asymptomatic, but they can grow larger and cause symptoms such as abdominal pain or discomfort, depending on their size and location.
Myelolipomas are rare tumors that typically affect middle-aged to older adults, with a slight female predominance. They are usually discovered incidentally during imaging studies performed for other medical conditions. In most cases, myelolipomas do not require treatment unless they cause symptoms or grow large enough to pose a risk of bleeding or rupture. Surgical removal is the standard treatment for symptomatic or complicated myelolipomas.
A lipoma is a common, benign (non-cancerous) soft tissue growth. It is composed of adipose or fatty tissue and typically found just beneath the skin, but they can also occur deeper within the body. Lipomas are usually round, moveable, and painless, although they may cause discomfort if they grow large enough to put pressure on nearby nerves or if they're located in a sensitive area. They generally grow slowly over time. Surgical removal is an option if the lipoma becomes bothersome or grows significantly in size. It's important to note that while lipomas are typically harmless, any new lumps or bumps should be evaluated by a healthcare professional to confirm the diagnosis and rule out other more serious conditions.
Vanilmandelic acid (VMA) is a metabolite produced in the body as a result of the breakdown of catecholamines, which are hormones such as dopamine, norepinephrine, and epinephrine. Specifically, VMA is the major end product of epinephrine and norepinephrine metabolism.
In clinical medicine, measurement of VMA in urine is often used as a diagnostic test for pheochromocytoma, a rare tumor that arises from the chromaffin cells of the adrenal gland and can cause excessive production of catecholamines. Elevated levels of VMA in the urine may indicate the presence of a pheochromocytoma or other conditions associated with increased catecholamine secretion, such as neuroblastoma or ganglioneuroma.
It's important to note that while VMA is a useful diagnostic marker for pheochromocytoma and related conditions, it is not specific to these disorders and can be elevated in other medical conditions as well. Therefore, the test should be interpreted in conjunction with other clinical findings and diagnostic tests.
Lipomatosis is a medical term that refers to a condition characterized by the abnormal growth of fatty tumors (lipomas) in various parts of the body. These lipomas are benign, soft, and rubbery masses made up of adipose or fatty tissue. Unlike isolated lipomas, which occur as solitary lumps under the skin, lipomatosis is a more widespread condition where multiple lipomas develop in a diffuse pattern, affecting a particular region or area of the body.
There are different types of lipomatosis, including:
1. Diffuse Lipomatosis: This type involves the growth of numerous small lipomas distributed throughout the subcutaneous tissue, giving the affected area a doughy feel and appearance.
2. Adiposis Dolorosa or Dercum's Disease: A rare condition characterized by painful and tender lipomas typically found in the trunk, arms, and legs. It primarily affects middle-aged women and can be accompanied by other systemic symptoms like fatigue, memory problems, and depression.
3. Multiple Symmetric Lipomatosis (MSL) or Madelung's Disease: This condition predominantly affects middle-aged men, particularly those with a history of alcohol abuse. It is characterized by the growth of large, symmetrical lipomas around the neck, shoulders, and upper trunk, leading to a "horse collar" appearance.
4. Familial Multiple Lipomatosis: An inherited condition where multiple benign fatty tumors develop in various parts of the body, usually appearing during adulthood. It tends to run in families with an autosomal dominant pattern of inheritance.
Treatment for lipomatosis typically involves surgical removal of the lipomas if they cause discomfort, limit mobility, or negatively impact a person's appearance. Regular monitoring and follow-up appointments with healthcare professionals are essential to ensure that no malignant changes occur in the lipomas over time.
Microscopy is a technical field in medicine that involves the use of microscopes to observe structures and phenomena that are too small to be seen by the naked eye. It allows for the examination of samples such as tissues, cells, and microorganisms at high magnifications, enabling the detection and analysis of various medical conditions, including infections, diseases, and cellular abnormalities.
There are several types of microscopy used in medicine, including:
1. Light Microscopy: This is the most common type of microscopy, which uses visible light to illuminate and magnify samples. It can be used to examine a wide range of biological specimens, such as tissue sections, blood smears, and bacteria.
2. Electron Microscopy: This type of microscopy uses a beam of electrons instead of light to produce highly detailed images of samples. It is often used in research settings to study the ultrastructure of cells and tissues.
3. Fluorescence Microscopy: This technique involves labeling specific molecules within a sample with fluorescent dyes, allowing for their visualization under a microscope. It can be used to study protein interactions, gene expression, and cell signaling pathways.
4. Confocal Microscopy: This type of microscopy uses a laser beam to scan a sample point by point, producing high-resolution images with reduced background noise. It is often used in medical research to study the structure and function of cells and tissues.
5. Scanning Probe Microscopy: This technique involves scanning a sample with a physical probe, allowing for the measurement of topography, mechanical properties, and other characteristics at the nanoscale. It can be used in medical research to study the structure and function of individual molecules and cells.