scholarly journals Clinical and morphological features of “inactive” pituitary adenomas: a retrospective analysis of 95 cases

1997 ◽  
Vol 43 (6) ◽  
pp. 26-30
Author(s):  
S. Yu. Kasumova ◽  
V. V. Vaks ◽  
B. A. Kadashev ◽  
E. I. Marova
Keyword(s):  
Pituitary Adenoma ◽  
Clinical Manifestations ◽  
Sexual Disorders ◽  
Pituitary Insufficiency ◽  
Electron Microscopic ◽  
Cell Adenoma ◽  
The Moment ◽  
Zero Cell ◽  
Immunohistochemical Studies ◽  
Sex Disorders

Ninety-five case histories of patients with “inactive ” pituitary adenoma are analyzed. These patients were operated on from 1977 to 1983, and the diagnosis was verified in them by histological, electron-microscopic, and immunohistochemical studies of the operation material. Clinical manifestations of the disease included a) neuroophthalmological symptoms; b) sexual disorders in men and women; c) pituitary insufficiency (hypogonadism, hypothyrosis, or hypocorticoidism); d) neurological and psychopathological symptoms. By the moment of the first manifestation of the symptoms the majority of patients were middle-aged. In older patients the disease starts with ocular and/or neurological disorders, in women under 50 and men under 55 years of age as a rule with sex disorders. Moderate hyperprolactinemia was detected in half of the patients, which in 30% of cases was associated with oligo-amenorrhea-galactorrhea often leading to hyperdiagnosis of prolactotrophic adenoma. In general, all types of inactive pituitary adenoma are chromophobic by their tinctorial properties, except oncocytoma, which is poorly eosinophilic in half the cases; electron microscopy showed zero-cell adenoma to be the most incident (40%) in the examined patient population.

scholarly journals Remote results of postoperative treatment of “inactive” pituitary adenoma

2001 ◽  
Vol 47 (1) ◽  
pp. 16-19
Author(s):  
V. V. Vaks ◽  
B. A. Kadashev ◽  
S. Yu. Kasumova ◽  
Ye. I. Marova
Keyword(s):  
Clinical Symptoms ◽  
Postoperative Treatment ◽  
Repeated Treatment ◽  
Electron Microscopic ◽  
Cell Adenoma ◽  
Common Category ◽  
Number Of Patients ◽  
Zero Cell ◽  
Immunohistochemical Studies ◽  
Treatment Surgery

A retrospective analysis of 77 case histories was carried out in order to evaluate patients’ status in remote period after surgery and analyze the relapses of "inactivepituitary adenomas" (IPA) with consideration for electron microscopy findings. IPA in the analyzed patients was verified by histological, electron-microscopic, and immunohistochemical studies. The patients (39 men and 38 women) were observed for 6-16 years after surgery. Two patients presented with endosellar adenoma, the rest with endoextrasellar adenoma. Adenomectomies were performed through a transcranial access in 69 (90%) patients and through the transnasosphenoid access in 8 (10%). Computer tomographic monitoring in immediate periods after surgery was carried out only in 12% patients, and therefore a more common category "disease relapse" was used for analysis of tumor relapses. Cases when clinical symptoms progressed because of obvious growth of radically or partially removed tumor and repeated treatment (surgery or radiotherapy) was needed were considered as relapses. Relapses occurred in 38 (49%) patients (20 men and 18 women). The highest percentage of relapses occurred in the zero-cell adenoma group (58%), while oncocytomas and undifferentiated adenomas relapsed equally often (46 and 44%, respectively). The mean duration of clinical manifestation of a relapse was virtually the same in all groups (6.9 ± 3.6 years, or 1-16 years). Visual functions improved in 60% cases and pituitary functions normalized in 23%, but the number of patients with hypopituitarism increased by 38%. That is why patients with IPA should be regularly checked up after surgery, as 66% of them develop symptoms of pituitary in sufficiency in remote postoperative period.

Intraventricular neurocytoma: clinicopathological analysis of seven cases

1992 ◽  
Vol 76 (5) ◽  
pp. 759-765 ◽  
Author(s):  
Dong Gyu Kim ◽  
Je G. Chi ◽  
Sung Hye Park ◽  
Kee Hyun Chang ◽  
Sun Ho Lee ◽  
...  
Keyword(s):  
Third Ventricle ◽  
Clinical Manifestations ◽  
Neuron Specific Enolase ◽  
Magnetic Resonance Images ◽  
Electron Microscopic ◽  
Content Type ◽  
Clinicopathological Analysis ◽  
Tomography Finding ◽  
Intraventricular Neurocytoma ◽  
Immunohistochemical Studies

✓ A retrospective analysis of seven patients with intraventricular neurocytoma is presented. Patient age at diagnosis ranged from 15 to 38 years (mean 24.6 years) and the male:female ratio was 6:1. Raised intracranial pressure due to hydrocephalus was the main cause of the clinical manifestations. An isodense mass with multiple intratumoral cysts and homogeneous contrast enhancement was the characteristic computerized tomography finding. The lesions commonly involved the lateral ventricle with or without extension to the third ventricle. Cerebral angiography showed homogeneous vascular staining in five patients. Magnetic resonance images revealed a mass isointense with the cerebral cortex on both T1 and T2-weighted images. Gadolinium-diethylenetriaminepenta-acetic acid-enhanced images showed homogeneous enhancement. Total removal of the tumor was possible in four patients. Pathologically, six cases were initially diagnosed as oligodendroglioma and the remaining case as ependymoma. However, immunohistochemical studies demonstrated strong positivity for neuron-specific enolase in all seven cases and for synaptophysin in five cases. On electron microscopy, three cases showed well-defined neurosecretory granules and 10-nm microtubules in their cytoplasm and cytoplasmic processes. One patient developed a recurrent tumor 18 months after surgery. The remaining six patients are free of recurrent tumors at 2 to 62 months after surgery. It is suggested that neurocytoma must be included in the differential diagnosis of intraventricular lesions, and that electron microscopic and immunohistochemical studies should be undertaken.

scholarly journals Clinical and morphological features of undifferentiated monomorphous GH/TSH-secreting pituitary adenoma

1999 ◽  
Vol 140 (6) ◽  
pp. 528-537 ◽  
Author(s):  
T Skoric ◽  
M Korsic ◽  
K Zarkovic ◽  
V Plavsic ◽  
N Besenski ◽  
...  
Keyword(s):  
Stem Cell ◽  
Pituitary Adenoma ◽  
Ct Scan ◽  
Secretory Granules ◽  
Clinical Manifestations ◽  
Residual Tumor ◽  
Morphological Features ◽  
Cell Adenoma ◽  
Lethal Arrhythmia ◽  
Adenoma Tissue

A 41-year-old male presented with progressive visual defects, acromegaly and hyperthyroidism. After clinical evaluation a giant GH/TSH-secreting pituitary adenoma was diagnosed. Administration of the somatostatin analog octreotide at doses of 150 microg s.c. per day inhibited the secretion of both GH and TSH. A three-week treatment with octreotide prior to surgery led to slight visual improvement and CT scan showed some new necrotic areas within the tumor mass. Transcranial surgery was performed. By immunohistochemical analyses of the adenoma tissue GH, prolactin and beta-chorionic gonadotropin were detected; TSH was negative. Electron microscopy revealed an undifferentiated, monomorphous adenoma with morphological features of an acidophil stem cell adenoma such as the presence of misplaced exocytoses, fibrous bodies and mitochondrial gigantism. However, the tumor cells contained small secretory granules (up to 250 nm) accumulated along the cell membrane characteristic of thyrotrope cells. Furthermore, some adenoma cells were fusiform with long cytoplasmic processes resembling thyrotropes. Two months after the operation CT scan revealed a large residual tumor. Serum GH and TSH levels had increased again and the TSH level was even higher than before the treatment. The patient died suddenly, most probably of lethal arrhythmia. Specimens of the adenoma tissue obtained at autopsy confirmed the previous findings with the exception of positive immunostaining for TSH which was found in less than 1% of the adenoma cells. This undifferentiated, monomorphous GH/TSH-secreting pituitary adenoma represents an entity that is unusual both in its ultrastructural features and clinical manifestations suggesting a cytogenesis from an early, undifferentiated stem cell.

Morphologic alteration in the muscles of patients with hypokalemic periodic paralysis or myopathy

1990 ◽  
Vol 48 (3) ◽  
pp. 222-223
Author(s):  
T. Shimizu ◽  
Y. Muranaka ◽  
I. Ohta ◽  
N. Honda
Keyword(s):  
Clinical Manifestations ◽  
Quadriceps Muscle ◽  
Honeycomb Structure ◽  
Periodic Paralysis ◽  
Ultrastructural Changes ◽  
Hypokalemic Periodic Paralysis ◽  
Electron Microscopic ◽  
Tubular Aggregates ◽  
Hypokalemic Myopathy ◽  
Transmission Electron

There have been many reports on ultrastructural alterations in muscles of hypokalemic periodic paralysis (hpp) and hypokalemic myopathy(hm). It is stressed in those reports that tubular structures such as tubular aggregates are usually to be found in hpp as a characteristic feature, but not in hm. We analyzed the histological differences between hpp and hm, comparing their clinical manifestations and morphologic changes in muscles. Materials analyzed were biopsied muscles from 18 patients which showed muscular symptoms due to hypokalemia. The muscle specimens were obtained by means of biopsy from quadriceps muscle and fixed with 2% glutaraldehyde (pH 7.4) and analyzed by ordinary method and modified Golgimethod. The ultrathin section were examined in JEOL 200CX transmission electron microscopy.Electron microscopic examinations disclosed dilated t-system and terminal cistern of sarcoplasmic reticulum (SR)(Fig 1), and an unique structure like “sixad” was occasionally observed in some specimens (Fig 2). Tubular aggregates (Fig 3) and honeycomb structure (Fig 4) were also common characteristic structures in all cases. These ultrastructural changes were common in both the hypokalemic periodic paralysis and the hypokalemic myopathy, regardless of the time of biopsy or the duration of hypokalemia suffered.

scholarly journals A study on the antibiotic resistance of Shigella

2016 ◽  
Vol 45 (2) ◽  
pp. 49
Author(s):  
Pramita G Dwipoerwantoro ◽  
Sri P Pulungsih ◽  
Nuraini I Susanti ◽  
Hartaniah Sadikin ◽  
Agus Firmansyah
Keyword(s):  
Shigella Flexneri ◽  
Clinical Manifestations ◽  
Stool Culture ◽  
Watery Diarrhea ◽  
Persistent Diarrhea ◽  
History Of ◽  
Hospital Morbidity ◽  
The Moment ◽  
Bloody Stools ◽  
Resistance Tests

Background The hospital morbidity caused by Shigella or dysen-tery ranges between 0.3 to 2.9%. Irrational use of antibiotics causesa persistent diarrhea and may lead to drug resistance.Objectives With various kinds of antibiotics available in Indone-sia at the moment, this study aimed to anticipate the kinds of anti-biotics appropriate for shigellosis and to evaluate the clinical spec-trum of dysentery in children in Indonesia.Method The study involved 50 children diagnosed with dysenteryor dysentery-like syndrome, aged 1 to 12 years, who came to fourdifferent hospitals in Jakarta, from November 2001 to April 2002.Parents were asked for their consent. Interviewers recorded de-tails of the children’s history of illness and the physical examina-tions. Stool culture and resistance tests were done.Results Fifty dysentery cases, comprising 30 males and 20 fe-males, 98% aged from 1 to 5 years, came to the four hospitalsduring the study period. Only 24 cases had positive Shigella cul-tures, of which 87% were Shigella flexneri and 17% were Shigellasonnei. The clinical manifestations of shigellosis were bloody stools(83%), mucus in the stool (75%), and watery diarrhea (96%). Fe-ver and tenesmus were absent in 67% and 92% of subjects, re-spectively. Almost 87% of shigellosis cases were resistant tocotrimoxazole; all were sensitive to colistin and most were sensi-tive to nalidixic acid.Conclusion This data suggests that colistin and nalidixic acid aredrugs of choice for dysentery syndrome. The clinical manifesta-tion of dysentery is not always accompanied by bloody stools butmostly incorporates watery diarrhea and mucus in the stool

scholarly journals Pituitary Melanocorticotrophinoma with Amyloid Deposition

1975 ◽  
Vol 2 (3) ◽  
pp. 199-202 ◽  
Author(s):  
Juan M. Bilbao ◽  
Kalman Kovacs ◽  
Eva Horvath ◽  
Hubert P. Higgins ◽  
William J. Horsey
Keyword(s):  
Fine Structure ◽  
Pituitary Adenoma ◽  
Structural Data ◽  
Amyloid Deposition ◽  
Perivascular Spaces ◽  
Adrenocorticotrophic Hormone ◽  
Cell Of Origin ◽  
Electron Microscopic ◽  
Melanocyte Stimulating Hormone ◽  
Microscopic Features

SUMMARY:The light and electron microscopic features of a pituitary adenoma composed of adrenocorticotrophic hormone (ACTH) and melanocyte stimulating hormone (MSH) cells with perivascular amyloid deposition is reported. Histochemical and fine structural data indicate that this material is APUDamyloid and is present in the extra-cellular perivascular spaces. It is suggested that the differences in fine structure and of distribution of the amyloid in pituitary adenomas is dependent upon the cell of origin.

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