Virtual or real: lifelike cinematic rendering of adrenal tumors

There have been few studies reported with conflicting results in the use of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), redcell-distribution-width (RDW), etc. for predicting prognosis and differential diagnosis of adrenal tumors. The aim of this study is to investigate the role of inflammatory markers through a complete blood count, which is an easy access low-cost method, for the differential diagnosis of adrenocortical adenoma (ACA), adrenocortical carcinoma (ACC), and pheochromocytoma. The data of patients who underwent adrenalectomy between the years of 2010–2020 were retrospectively analyzed. Systemic hematologic inflammatory markers based on a complete blood count such as neutrophil ratio (NR), lymphocyte ratio (LR), NLR, PLR, RDW, mean platelet volume (MPV), and maximum tumor diameter (MTD) were compared between the groups. A statistically significant difference was found between the three groups in terms of PLR, RDW, and MTD. With post-hoc tests, a statistically significant difference was found in PLR and MTD between the ACA and ACC groups. A statistically significant difference was found between the ACA and pheochromocytoma groups in PLR and RDW values. In conclusion, it could be possible to plan a more accurate medical and surgical approach using PLR and RDW, which are easily calculated through an easy access low-cost method such as a complete blood count, together with MTD in the differential diagnosis of ACC, ACA, and pheochromocytoma.

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Cinematic rendering of a burst sagittal suture caused by an occipito-frontal gunshot wound

Forensic Science Medicine and Pathology ◽

10.1007/s12024-021-00387-9 ◽

2021 ◽

Author(s):

Dominic Gascho ◽

Michael J. Thali ◽

Rosa M. Martinez ◽

Stephan A. Bolliger

Keyword(s):

Gunshot Wound ◽

Three Dimensional ◽

The Novel ◽

Sagittal Suture ◽

Resonance Imaging ◽

Cinematic Rendering ◽

Reconstruction Methods ◽

Dimensional Reconstruction ◽

Magnetic Resonance Imaging Mri ◽

The Brain

AbstractThe computed tomography (CT) scan of a 19-year-old man who died from an occipito-frontal gunshot wound presented an impressive radiating fracture line where the entire sagittal suture burst due to the high intracranial pressure that arose from a near-contact shot from a 9 mm bullet fired from a Glock 17 pistol. Photorealistic depictions of the radiating fracture lines along the cranial bones were created using three-dimensional reconstruction methods, such as the novel cinematic rendering technique that simulates the propagation and interaction of light when it passes through volumetric data. Since the brain had collapsed, depiction of soft tissue was insufficient on CT images. An additional magnetic resonance imaging (MRI) examination was performed, which enabled the diagnostic assessment of cerebral injuries.

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High Diagnostic and Prognostic Value of Steroidogenic Factor-1 Expression in Adrenal Tumors

Endocrinology ◽

10.1210/endo.151.8.9992 ◽

2010 ◽

Vol 151 (8) ◽

pp. 4066-4066

Author(s):

Silviu Sbiera ◽

Sebastian Schmull ◽

Guillaume Assie ◽

Hans-Ullrich Voelker ◽

Luitgard Kraus ◽

...

Keyword(s):

Prognostic Value ◽

Adrenal Tumors ◽

Steroidogenic Factor 1 ◽

Diagnostic And Prognostic Value

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Differentiating Benign from Malignant Adrenocortical Tumors by a Single Morphological Parameter—a Clinicopathological Study on 837 Adrenocortical Neoplasias

Indian Journal of Surgical Oncology ◽

10.1007/s13193-020-01205-4 ◽

2020 ◽

Vol 11 (4) ◽

pp. 705-710

Author(s):

Martin K. Walz ◽

Klaus A. Metz ◽

Sarah Theurer ◽

Cathrin Myland ◽

Pier F. Alesina ◽

...

Keyword(s):

Adrenocortical Carcinoma ◽

Tumor Necrosis ◽

Morphological Differentiation ◽

Scoring Systems ◽

Distant Metastases ◽

Adrenal Tumors ◽

Control Group ◽

Consecutive Series ◽

Morphological Parameter ◽

Adrenocortical Tumors

AbstractThe morphological differentiation between benign and malignant adrenocortical tumors is an ongoing problem in diagnostic pathology. In recent decades the complex scoring systems have been widely used to calculate the probability of malignancy in adrenocortical tumors on the basis of a variety of histomorphological parameters. We herewith present a substantially simplified method to diagnose adrenocortical carcinoma by a single histomorphological parameter on a consecutive series of more than 800 adrenocortical tumors. Between January 2000 and May 2019, altogether 2305 adrenalectomies for of all types of diseases were removed, approximately 98% by minimally invasive approaches. After exclusion of pheochromocytomas, adrenal ganglioneuromas, adrenal metastases, Cushing’s disease related specimens, and Conn’s adenomas, the present series finally consisted of 837 adrenocortical tumors. All tumors were analyzed by experienced pathologists of a single institution using standard histopathological methods (Hematoxylin-Eosin and Ki67 stained sections). Clinical and histopathologic data were prospectively collected and retrospectively analyzed. Clinically, 385 patients had 420 functioning tumors (FT), and 417 had non-functioning adrenal tumors (NFT). The mean size of FT was 3.8 ± 1.4 cm (range 0.5–16 cm) and for NFT 4.5 ± 1.6 cm (range 1.5–18 cm). Histomorphologically, 32 adrenal tumors were classified as adrenocortical carcinoma (ACC; 3.8%). In all 32 cases (tumor size 9.1 ± 4.0 cm, range 3–18 cm), confluenting tumor necrosis could be demonstrated. The remaining 805 tumors (control group) completely lacked this highly reproducible single morphological feature. Ki67 levels above 10% were found in 31 of 32 ACCs and never in adrenocortical adenomas (ACA). With a mean follow-up of 8.2 years, 24 out of 32 patients primarily diagnosed as ACC developed distant metastases (75.0%), whereas all patients in the control group remained free of local or distant recurrence. We conclude that a single morphological parameter (confluenting tumor necrosis) is sufficient to predict a poor clinical course in adrenocortical tumors. The histomorphological diagnosis of this parameter is straightforward and highly reproducible.

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