Adrenal Cortex Neoplasms ; complications ; Adrenal Gland Neoplasms ; complications ; Adrenal Glands ; pathology ; Adrenocortical Adenoma ; complications ; Humans ; Pheochromocytoma ; complications

BACKGROUNDAlveolar echinococcosis located in the adrenal gland can be considered a rare and aggressive infestation that radiologically and macroscopically mimics a malignant neoplasm. Its pathogenesis is poorly understood. This paper describes its clinical and radiological aspects and discusses its proper management.

METHODSThe records of two patients with adrenal gland alveolar echinococcosis who were diagnosed and treated in our center in 2009 were evaluated.

RESULTSNeither patient showed any signs of recurrence following radical surgical treatment and postoperative oral anthelmintic therapy.

CONCLUSIONRadical surgery can be a feasible, effective management option that results in a good prospective outcome.

Adrenal Glands ; pathology ; surgery ; Echinococcosis, Hepatic ; diagnosis ; surgery ; Female ; Humans ; Male ; Middle Aged

Radilogy plays an important role in evaluating patients with suspected adrenal gland pathology. Morphologicdelineation of adrenal gland is especially valuable in patients with clinical and/or biochemical evidence of adisturbance in adrenal function. Many diagnostic radiologic methods are avilable for demonstrating adrenallesions. CT overcomes many of the disadvantages of these other radiologic techniques. The high degree of spatialand density resolution allows precise demonstration of the normal adrenal glands as well as detection of bothsmall and large tumors in almost all patients. So CT of adrenal gland is an excellet nonivasive screening methodand definitive imaging technique. The authers have investigated the capability of CT to image the nomral size,location and shape of both glands. Knowledge of the range of normal is useful for optimal interpretation of CTscans in patients with suspected aderenal pathology. We reviewed CT scan of 150 cases without evidence of adrenaldisease. The following results were obtained: 1. There were 90 male and 60 female patients. 2. Their ages rangedfrom 20 to 60 years. 3. On CT, both gland were shown in 135 (90.0%), the right in 143(95.3%), the left in142(94.6%). 4. In the shape of adrenal glands, most of right adrenal gland was linear or comet shaped; 68(47.6%),most of left adrenal gland was inverted-Y shaped: 103(72.6%). 5. In the length of adrenal glands, theright was2.5+-0.77cm, the left was 2.9+-0.75cm. 6. In the width of adrenal glands, the right was 3.2+-0.74cm, the left was2.7+-0.57cm. 7. In the thickness of adrenal glands, the right was 0.5+-0.14cm, the left was 0.6+-0.16cm.
Adrenal Glands ; Female ; Humans ; Male ; Mass Screening ; Pathology ; Pheniramine ; Tomography, X-Ray Computed

Adrenal Gland Neoplasms ; pathology ; Adrenal Glands ; pathology ; Adult ; Aged ; Female ; Humans ; Lymphoma ; pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Positron-Emission Tomography

OBJECTIVESeven cases of autopsy from SARS patients are studied to investigate the pathogenesis and the pathologic changes of the major organs.

METHODSDetailed gross and microscopic examination of the autopsy specimen is performed, including lung, heart, liver, kidney, spleen and lymph nodes.

RESULTSAll of the lungs are markedly enlarged and consolidated. Microscopically, pulmonary edema is a prominent finding, especially at the early stage of the disease (5 days after the onset). The alveolar spaces are filled with fibrinous exudates and lined with hyaline membrane. In 5 cases that undergo over 3 weeks of the course, the main pattern is organization of intra-alveolar deposit, along with fibroblastic proliferation in the alveolar septa, which leads to obliteration of alveolar space and pulmonary fibrosis. All of the lungs show bronchopneumonia, scattered hemorrhage, and proliferation of alveolar epithelial cells with desquamation. Microthrombi are seen in 6 cases. Fungal infection is noted in 2 cases. One of them is disseminative, involving bilateral lungs, heart, and kidney; the other one is diagnosed in hilar lymph nodes. In immune system, hilar and abdominal lymph nodes are usually congested and hemorrhagic, with depletion of lymphocytes, and accompanied with subcapsular sinus histiocytosis. One of the cases shows enlargement of abdominal lymph nodes, which have reduced number of germinal centers. Spleen exhibits atrophy of white pulps, and even lost of white pulps in some areas. The red pulp is markedly congested and hemorrhagic. In 5 cases, cardiomegale is prominent. Thrombosis (2 cases), focal myocarditis (1 case), and fungal myocarditis (1 case) are observed. In addition, liver shows massive necrosis (1 case) and nodular cirrhosis (1 case).

CONCLUSIONSLung is the major organ affected by SARS, demonstrated as diffuse alveolar damage. It is postulated that viral infection induces severe damage of alveolar epithelial and capillary endothelial cells, leads to pulmonary edema, intra-alveolar fibrin deposit, and hyaline membrane formation. Consequently, intra-alveolar organization and alveolar septal fibrosis causes loss of alveolar spaces, eventually, pulmonary fibrosis and atelectasis. The immune system is often affected, and presented as depletion of lymphoid tissue in lymph nodes and spleen. Secondary infection is a common complication, which should be paid close attention in the management of SARS patients.

Adrenal Glands ; pathology ; Adult ; Autopsy ; Bone Marrow ; pathology ; Female ; Humans ; Kidney ; pathology ; Liver ; pathology ; Lung ; pathology ; Male ; Middle Aged ; Myocardium ; pathology ; Severe Acute Respiratory Syndrome ; pathology ; Spleen ; pathology

Bronchogenic cysts are generally found in the mediastinum, particularly posterior to the carina, but they rarely occur in such unusual sites as the skin, subcutaneous tissue, pericardium, and even the retroperitoneum. A 30-year-old Korean man underwent surgery to remove a cystic adrenal mass incidentally discovered during routine physical checkup. At surgery, it proved to be a multilocular cyst located in the retroperitoneum adjacent to the left adrenal gland. Microscopically, the cyst was lined by respiratory epithelium over connective tissue with submucous glands, cartilage and smooth muscle, thereby histologically confirming bronchogenic cyst. This is the first reported case of retroperitoneal bronchogenic cyst in an adult without other congenital anomalies in Korea.
Adrenal Glands/pathology* ; Adult ; Bronchogenic Cyst/pathology* ; Bronchogenic Cyst/diagnosis ; Case Report ; Diagnosis, Differential ; Human ; Male ; Retroperitoneal Space

PURPOSE: The laparoscopic adrenalectomy (LA) has become the preferred procedure for adrenal tumors due to many advantages; a more rapid and comfortable recovery, shortened hospitalization period, and fewer complications. This study reports on an initial 4 year period of experience with LA and describes various unusual findings encountered during the treatment. METHODS: From February 1997 to November 2000, a total of 20 LA were performed. Of the several LA techniques previously described we prefer the transabdominal approach in the lateral decubitus position utilizing 3 or 4 trocars, and this method was employed in all the cases presented here. RESULTS: All 20 patients had a unilateral tumor. The pathological findings consisted of 11 aldosteronomas, 6 Cushing adenomas, 2 pheochromocytomas and 1 cortical carcinoma. Of the 20 patients, 18 were successfully operated with the laparoscopic procedure and the remaining 2 cases were converted to open adrenalectomy. The reasons for conversion were sudden cardiac arrest of unknown origin in one and intraoperative bleeding due to periadrenal massive fat in the other. During LA, 2 patients with non-catecholamine-secreting cortical adenomas pathologies displayed abnormal EKG findings, which reverted to normal after the operation. The average complete LA operation times was 186 minutes in the first 9 cases and 132 minutes in the next 9 cases. The first oral intake was started within 24 hours in all cases. There were no postoperative complications, operative morbidity or mortality. The average hospital stay was 6.2 days in the first 9 cases and 4.2 days in the next 9 cases. CONCLUSION: LA is a relatively fast and safe method and has become is accepted as the preferred procedure for adrenal tumors but it requires good perioperative preparation. Surgeons and anesthesiologists need to be aware of the possible cardiovascular complications and of the problems inherent in the manipulation of the adrenal gland during LA.
Adenoma ; Adrenal Glands ; Adrenalectomy* ; Death, Sudden, Cardiac ; Electrocardiography ; Hemorrhage ; Hospitalization ; Humans ; Length of Stay ; Mortality ; Pathology ; Pheochromocytoma ; Postoperative Complications ; Surgical Instruments

Adrenal Glands ; metabolism ; Androgens ; metabolism ; Gene Amplification ; Humans ; Male ; Orchiectomy ; Prostatic Neoplasms ; metabolism ; pathology ; surgery ; Receptors, Androgen ; metabolism

PURPOSE: In this study, we reviewed 16 cases of adrenalectomy, focusing specifically on the surgical outcomes and clinical courses.METHODS: The data from 16 patients who underwent an adrenalectomy at our hospital between January 2007 to December 2016 were retrospectively analyzed based on their medical records. Data available for each patient included age, sex, tumor location, length of postoperative hospital stay, tumor size, tumor pathology, final diagnosis, operation time, operative blood loss, and type of operation.RESULTS: The study population consisted of eight males and eight females, with a mean age of 58.00±11.34 years (range, 33–76 years). The mean tumor size was 2.78±2.02 cm (range, 0.5–7 cm). Fourteen patients were diagnosed with functional adrenal tumors and two with nonfunctional adrenal tumors. Compared to laparoscopic adrenalectomy, open surgery resulted in a statistically significantly longer operating time, increased operative blood loss, and a longer postoperative hospital stay.CONCLUSION: If the hormonal activity of adrenal tumors is not confirmed, the tumor should be considered functional when accompanied by related symptoms and an adrenalectomy should be performed. In addition, we suggest that a laparoscopic adrenalectomy is superior to an open adrenalectomy in terms of recovery after surgery, despite the small number of cases evaluated. Open adrenalectomy should be considered following comprehensive consideration of the patient's condition, such as accompanying surgery or metastatic cancer.
Adrenal Glands ; Adrenalectomy ; Diagnosis ; Female ; Humans ; Laparoscopy ; Laparotomy ; Length of Stay ; Male ; Medical Records ; Operative Time ; Pathology ; Retrospective Studies

Adrenal Glands ; pathology ; Codon, Nonsense ; Exons ; Female ; Humans ; Infant ; Liver ; pathology ; Spleen ; pathology ; Sterol Esterase ; genetics ; Tomography, X-Ray Computed ; Wolman Disease ; diagnostic imaging ; genetics ; pathology