Cases Of Hyperplasia Research Articles

Clinical Observation of Ginger Partitioned Moxibustion Combined with Acupuncture in the Treatment of Breast Fibroma

To investigate the clinical efficacy of ginger partitioned moxibustion combined with acupuncture in the treatment of breast fibroma. 128 cases of breast hyperplasia combined with breast fibroma in our hospital from June 2018 to June 2020 were selected as the research object, and they were randomly divided into the observation group and the control group, 64 cases in each group. The patients in the control group were given Rupixiao, 5 tablets each time, 3 times a day, while the patients in the observation group were treated with ginger partitioned moxibustion combined with acupuncture for 3 mo. The levels of sex hormones (luteinizing hormone, estradiol, prolactin and progesterone), the pathological characteristics of color Doppler ultrasound and the changes of quality of life of the two groups before and after treatment were observed and analyzed, and the therapeutic effect was evaluated. After treatment, the estradiol and prolactin levels of the two groups were lower than before treatment, Progesterone and luteinizing hormone levels were higher than before treatment, and the estradiol and prolactin levels of the observation group were lower than those of the control group, progesterone and luteinizing hormone levels were higher than those of the control group, the differences were statistically significant (p<0.05); After treatment, the thickness of mammary gland layer, the diameter of mass, the inner diameter of breast duct and the diameter of hypoechoic area of the two groups were lower than before treatment, and the observation group was lower than the control group, the difference was statistically significant (p<0.05); After treatment, the quality of life Generic Quality of Life Inventory-74 scores (including material life, physical function, social function, psychological function and total score) of the two groups were significantly improved (p<0.05), and the observation group was significantly better than the control group in improving the quality of life scores; The total effective rates of the observation group and the control group were 95.0 % and 83.3 % respectively, and the difference between the two groups was statistically significant (p<0.05). Ginger partitioned moxibustion combined with acupuncture in the treatment of patients with breast fibroma has a good effect, which can effectively improve the level of sex hormones, promote the recovery of the disease, and improve the quality of life of patients.

Lymphotoxin-α C804A polymorphism and the presence of simple endometrial hyperplasia in Egyptian women

ABSTRACT Endometrial hyperplasia (EH) is found to be a common diagnosis in women presenting with abnormal uterine bleeding, in advanced stages leading to cancer. To test the association of endometrial hyperplasia with the lymphotoxin-α (LT-α) C804A polymorphism, a case–control study was performed in Egyptian subjects. The cases comprised 100 endometrial hyperplasia patients, and the controls were 120 females served as control. Results showed that C allele versus A allele was compared in Simple Endometrial hyperplasia (SEH) cases compared to controls, there was no significant difference. In pre-menopausal cases, using the CC genotype as the reference genotype, the CA genotype was associated with a significantly elevated OR of 3.36 (95% CI =1.3–8.2, P = 0.007) in SEH cases compared to control. In addition, dominant genotypes (AA plus CA) were significantly increased in SEH cases compared to controls (OR =0.36, 95% CI =0.15–0.84, P =0.01). In conclusion, the common Lymphotoxin- α C804A polymorphism gene is associated with an increased risk of simple endometrial hyperplasia.

A Tale of Two Benign Hepatic Nodules with Pulmonary Hypertension

Nodular regenerative hyperplasia and hepatocellular adenoma are two benign liver lesions with low risk of malignant potential. Nodular regenerative hyperplasia appears to be result of adaptive reaction to hepatic vasculopathy. Hepatocellular adenoma is associated with use of estrogen, anabolic steroids, metabolic disease and rarely vascular abnormality. We report an unusual case of a young female who presented with progressive dyspnoea, cough and edema. She succumbed to her illness within two days of her hospital stay. A medical autopsy was performed which revealed hepatocellular adenoma arising on the background of nodular regenerative hyperplasia along with pulmonary hypertension and intrapulmonary hemorrhage. Unusual case of nodular regenerative hyperplasia and hepatocellular adenoma associated with pulmonary hypertension where vascular pathology is suggested as a common event in their pathogenesis. Hence, it is advisable to rule out associated conditions with the help of imaging techniques in patients with pulmonary hypertension.

The Expression and Significance of CyclinD2 and Bcl-2 in Diffuse Large B-cell Lymphoma

Objectives: To study the expression and significance of cyclinD2 and Bcl-2 in diffuse large B-cell lymphoma. Methods: This project used immunohistochemical methods to detect the expression of cyclinD2 and Bcl-2 in 120 cases of diffuse large B-cell lymphoma and 80 cases of reactive hyperplasia of lymphoid tissue. The materials were collected from the hospital from January 2018 to 2020. In March 2015, 120 patients had lymphoma tissue removed during the month of surgery. The postoperative pathological diagnosis was DLBCL. Another 80 cases of lymphoid hyperplasia (RLH) tissues were selected as controls. Results: CyclinD2 and BCL-2 expression were not statistically different in patients with diffuse large B-cell lymphoma in different ages, genders, locations, tissue types, and degree of differentiation; but statistically significant in different Ann Arbor stages, immunotypes, IPI index and first treatment efficacy. Conclusion: This research not only has important theoretical value, but also important economic value and social significance.

Colon capsule endoscopy in patients with chronic respiratory disease during the COVID‐19 pandemic

Dear Editor, We read with interest the article by MacLeod et al. [1]. The authors suggest that colon capsule endoscopy (CCE) could be a useful tool for triaging emergency colonoscopy during the COVID-19 pandemic. The literature for CCE in patients with chronic respiratory disease, who comprise one of the COVID-19 high-risk groups [2], is limited. We carried out a retrospective study of CCE in patients with chronic respiratory disease up to May 2020, the first wave of the COVID-19 pandemic in Japan. Thirty-one patients (18 men and 13 women with a mean age of 65.2 ± 15.1 years) with chronic respiratory disease who underwent CCE at our hospital were included. The diagnoses of these patients were pulmonary emphysema in seven patients, bronchial asthma in seven patients, chronic bronchitis in six patients, sleep apnoea syndrome in two patients, pulmonary tuberculosis (old and latent) in eight patients and nontuberculous mycobacteriosis in one patient. The reasons for the procedure were as follows: screening in seven patients, positive for a faecal occult blood test in four patients, lower abdominal pain in five patients, diarrhoea in two patients, abnormal bowel movement in five patients, narrowing of the stool column in one patient, follow-up for Crohn's disease in one patient, suspicion of irritable bowel syndrome in three patients and accumulation of positron emission tomography in the transverse colon in one patient. The overall total colorectal detection rate using CCE was 90.3% (28/31). Polyps were detected in 54.8% of patients by CCE (17/31 cases), and a significant finding (polyp lesion of 6 mm or more) was observed in 64.7% (11/17 cases). Colonoscopy (CS) was performed in 45.1% (14/31). The positive predictive value was 100% (17/17 patients) and the negative predictive value (13/14 patients) was 92.9%. Histopathological examination by therapeutic endoscopy using CS with personal protective equipment revealed six cases of adenoma, six cases of hyperplasia, one case of carcinoma in situ and no advanced cancer. There were no adverse events, such as retention, in any patient and no evidence of SARS-Cov-2 infection in healthcare professionals. There is a report suggesting the possibility of colon CT examination [3] and positron emission tomography [4] as an alternative method during the COVID-19 pandemic. However, CCE is free from radiation exposure and the only examination that can be performed at home without coming to hospital during the pandemic. CCE is expensive, it costs the national health insurance adaptation of Japan approximately ￥30 000 at a 30% burden. However, it can be easily inferred that in patients with chronic respiratory disease it is more cost-effective than the medical cost of ventilators and extracorporeal membrane oxygenation in intensive care units if they become seriously ill with SARS-Cov-2 infection. Also, in Japan, CCE was adopted by the national health insurance plan for chronic obstructive pulmonary disease from March 2020. Our study results suggest that CCE in patients with chronic respiratory disease avoids unnecessary CS and may reduce the risk of SARS-Cov-2 infection by CS in approximately 60% of the patients. All patients consented to data collection, analysis and dissemination. The author participated in the interpretation of study results, and in the drafting, critical revision, and approval of the final version of the manuscript. I declare no conflict of interests. This study was approved by the ethics committee. The data that support the findings of this study are openly available in [repository name e.g. “figshare”] at 10.6084/m9.figshare.13278059.

Application of endoscopic submucosal dissection in duodenal space-occupying lesions.

BACKGROUNDEndoscopic submucosal dissection (ESD) has been advocated by digestive endoscopists because of its comparable therapeutic effect to surgery, reduced trauma, faster recovery, and fewer complications. However, ESD for lesions of the duodenum is more challenging than those occurring at other levels of the gastrointestinal tract due to the thin intestinal wall of the duodenum, narrow intestinal space, rich peripheral blood flow, proximity to vital organs, and high risks of critical adverse events including intraoperative and delayed bleeding and perforation. Because of the low prevalence of the disease and the high risks of severe adverse events, successful ESD for lesions of the duodenum has rarely been reported in recent years.AIMTo investigate the efficacy and safety of ESD in the treatment of duodenal space-occupying lesions.METHODSClinical data of 24 cases of duodenal lesions treated by ESD at the Digestive Endoscopy Center of the Affiliated Hospital of Qingdao University from January 2016 to December 2019 were retrospectively analyzed.RESULTSAll of the 24 cases from 23 patients underwent ESD treatment for duodenal space-occupying lesions under general anesthesia, including 15 male and 8 female patients, with a mean age of 58.5 (32.0-74.0) years. There were 12 lesions (50%) in the duodenal bulb, 9 (37.5%) in the descending part, and 3 (12.5%) in the ball-descending junction. The mean diameter of the lesion was 12.75 (range, 11-22) mm. Thirteen lesions originated from the mucosa, of which 4 were low-grade intraepithelial neoplasia, 3 were hyperplastic polyps, 2 were chronic mucositis, 2 were adenomatous hyperplasia, 1 was high-grade intraepithelial neoplasia, and 1 was tubular adenoma. Eleven lesions were in the submucosa, including 5 neuroendocrine neoplasms, 2 cases of ectopic pancreas, 1 stromal tumor, 1 leiomyoma, 1 submucosal duodenal adenoma, and 1 case of submucosal lymph follicular hyperplasia. The intraoperative perforation rate was 20.8% (5/24), including 4 submucosal protuberant lesions and 1 depressed lesion. The mean length of hospital stay was 5.7 (range, 3-10) d, and the average follow-up time was 25.8 (range, 3.0–50.0) mo. No residual disease or recurrence was found in all patients, and no complications, such as infection and stenosis, were found during the follow-up period.CONCLUSIONESD is safe and effective in the treatment of duodenal lesions; however, the endoscopists should pay more attention to the preoperative preparation, intraoperative skills, and postoperative treatment.

Evaluation of Gall Bladder Mucosal Changes in Relation to the Type of Stones in Patients Undergoing Laparoscopic Cholecystectomy: A Retrospective Study of 394 Patients

Background and Aim Gallbladder (GB) cancer is a highly fatal malignancy and approx. 10% new cases are diagnosed every year in India. The GB cancer has poor prognosis due to progressive nature. Understanding of risk factors that lead to GB development is urgently required for better management of the disease. Presence of stones in gall bladder generates varied mucosal reactions, which leads to different types of histopathological changes in mucosa. Here, our aim is to study the correlation between various types of mucosal responses e. g. inflammation, hyperplasia, metaplasia and carcinoma with different characteristics e. g. number and morphology of gallstones both in males and females. Materials and Methods A retrospective study of gallstones was performed on 438 cases of cholecystectomies operated laparoscopically based on the histological changes. Out of 438 cases, 394 (89.95%) were associated with gallstones and the rest 44 (10.05%) belonged to acalculous cholecystitis. The mucosal changes in calculous gall bladder were studied in 394 cases and its correlation with number and types of observed gallstones were evaluated. Tissue sections were taken from the fundus, body, neck and abnormal area of gallbladder for histopathological studies. Results Our study has revealed the higher incidence of inflammatory changes in males, while gall bladder hyperplasia, intestinal metaplasia and cancer cases were found mostly in females. Conclusion Our study showed that changes in the number and morphology of gallstones are directly associated with the mucosal changes in gallbladder e.g. inflammation, hyperplasia, metaplasia and gall bladder carcinoma

Hiperplasia Nodular Histiocítica: Uma Manifestação Rara à Exposição ao Asbesto

A hiperplasia nodular histiocítica (HNH) consiste em uma condição rara, sem predileção por sexo ou idade, marcada por um processo proliferativo benigno, por vezes confundido com neoplasia maligna, constituído majoritariamente por histiócitos (1, 2). Inflamação crônica local e irritação mecânica estão entre as principais causas postuladas para essa entidade. Patologias malignas, por outro lado, representam os principais diagnósticos diferenciais, o que evidencia a importância clínica de seu diagnóstico assertivo sendo a imunohistoquímica uma importante ferramenta diagnóstica (3). Nesse artigo, os autores descrevem um relato de caso de hiperplasia nodular histiocítica pleuro-pulmonar em um paciente do sexo masculino, não tabagista, com história de exposição ao asbesto o qual provavelmente incitou um processo inflamatório crônico com proliferação de histiócitos. O paciente apresentava dispnéia, dor pleurítica e hemoptise além de derrame pleural hemorrágico recorrente evoluindo a óbito por exacerbação dos sintomas. Apesar da entidade ser descrita na literatura como uma proliferação celular benigna histiocitária, há raros casos relatados sobre a evolução e tratamento da doença.&#x0D; Palavras chaves: Hiperplasia nodular histiocítica, asbesto, pleura, pulmão.&#x0D;

Levonorgestrel intrauterine system for endometrial protection in women with breast cancer on adjuvant tamoxifen.

Levonorgestrel intrauterine system for endometrial protection in women with breast cancer on adjuvant tamoxifen.

Bioidentical Oral 17β-Estradiol and Progesterone for the Treatment of Moderate to Severe Vasomotor Symptoms of Menopause

To review the efficacy, safety, and available literature regarding the novel combination bioidentical product Bijuva, or 17β-estradiol/progesterone (17β-E/P), for the treatment of moderate to severe menopausal symptoms in cisgender females with an intact uterus. Literature searches of both PubMed (1966 to October 2020) and Google Scholar were conducted using search terms including bioidentical, estradiol, progesterone, menopause, E2/P4, TX-001HR, and Bijuva. All articles with studies conducted in cisgender human females and in the English language were considered for review; 18 publications were included. In 1 phase 3 clinical study, 17β-E/P was proven to be effective at reducing the frequency and severity of vasomotor symptoms (VMS) at 12 weeks compared with placebo, and no cases of endometrial hyperplasia were observed over the 52-week safety study period. Menopausal women with an intact uterus were included in the study population. Concerns over content and safety of compounded bioidentical hormones have been raised by several professional societies. As women experience VMS of menopause, a desire for a Food and Drug Administration-regulated bioidentical combination product for the treatment of moderate to severe menopausal symptoms may be desirable. Given as a once-daily oral capsule at the dose of 1 mg estradiol/100 mg progesterone, 17β-E/P is approved for the treatment of VMS associated with menopause. 17β-E/P is a novel bioidentical product that is the first of its kind in the treatment of moderate to severe menopausal symptoms.

A Comparative Study of Expression of PTEN and p53 in Endometrial Hyperplasia and Carcinoma in a Tertiary Care Hospital

Context: A comparison of PTEN and p53 expression in endometrial hyperplasia and carcinoma. Aims: To study the histomorphology and expression of PTEN and p53 markers in endometrial hyperplasia and carcinoma in histopathology samples. Settings and Design: This is a comparative study done on 40 cases of endometrial hyperplasia and 20 cases of endometrial carcinoma. Methods and Material: This is a 2 year study done on 40 cases of endometrial hyperplasia and 20 cases of endometrial carcinoma in a tertiary care hospital. Endometrial biopsies and resected specimens of uterus received at pathology department were grossed, processed and were stained by hematoxylin and eosin and examined by the pathologist. The expression of PTEN and p53 markers was evaluated on the diagnosed samples. Results: Out of 36 cases of endometrial hyperplasia without atypia, 4 atypical hyperplasias and 20 endometrioid carcinomas, loss of PTEN expression was found to be 16.7%, 25% and 80% respectively, whereas expression of p53 was found to be 5.6%, 75% and 90% respectively in the same cases. Conclusions: The loss of PTEN expression or positive expression of p53 in hyperplasias may be used as an early indicator of progression to carcinoma. The altered expressions of these markers are initiated in few cases of hyperplasia, which may progress to atypical hyperplasia, a premalignant lesion and ultimately develop into carcinoma.

Immunohistochemical study of ER, PR, p53 and Ki67 expression in patients with endometrial adenocarcinoma and atypical endometrial hyperplasia

To study Immunohistochemistry pattern of ER, PR, p53 and Ki67 expression in patients with endometrial adenocarcinoma (EC) and endometrial hyperplasia. A retrospective study of 78 cases were studied for a period of 02 year from June 2018 to May 2020, where in the clinical data included age, presenting complaints, menopausal status, history of hormonal treatment, ultrasound examination.Histopathological parameters were analysed as per WHO 2014 classification of endometrial hyperplasia into typical and atypical endometrial hyperplasia / Endometrial Intraepithelial Neoplasia (EIN) and endometrial carcinoma. ER, PR, p53 and Ki 67 IHC markers were done on cases diagnosed as endometrial adenocarcinoma and endometrial hyperplasia. Among 78 cases, there were 20 cases of EC and 58 cases of endometrial hyperplasia. EC was most commonly seen in sixth to seventh decade and hyperplasia was seen in fourth to fifth decade .There were 11 surgical specimens and 09 biopsies of EC. Out of total 20 cases, there were 17 cases of endometrioid adenocarcinoma and 03 cases were of papillary serous adenocarcinoma.ER, PR expression was seen in 10 cases of grade 1 endometrial carcinomas and 5 cases of grade 2 EC. p53 expression was seen in 01 case of grade 1 EC and 03 cases grade 3 EC. ER, PR, p53 all were negative in one case. Ki67 was &amp;#60;10% in 11 cases, between 10-20% in 5 cases and &amp;#62;20% in 04 cases. We followed up 15 out of 20 cases, out of which only 01 patient died of disease who was grade 1 endometrial carcinoma. Rest 14 had progression free survival (PFS) till date.All 58 cases of endometrial hyperplasia were reclassified complex and simple hyperplasia to typical and atypical hyperplasia (as per WHO Classification 2014). Out of 58 cases, 56 cases were typical hyperplasia and 02 cases atypical hyperplasia. ER, PR expression was positive in all the cases of typical and atypical hyperplasia. p53 expression was absent in typical and atypical hyperplasia with low Ki 67 index (&amp;#60;10%). High ER, PR expression along with low p53 was seen in type 1 endometrial carcinomas compared to low or absent ER, PR along with strong p53 expression in papillary serous carcinoma (Type 2). The expression of ER, PR was high in typical hyperplasia as against high p53 expression observed in atypical hyperplasia.

Effect of metabolic syndrome on treatment outcome of lower urinary tract symptoms in males due to benign prostatic hyperplasia

Lower urinary tract symptoms in males are mostly due to benign prostatic hyperplasia and overactive bladder. Approximately three-fourths of them require medical management with drugs like a1blockers and 5-a reductase inhibitors. Metabolic syndrome[MeS] as a comorbidity has been documented with a number of cases of benign prostatic hyperplasia [BPH]. The present study finds MeS as a potential risk factor for BPH and compares the effectiveness of BPH medications among those with and /or without underlying MeS. Patients were evaluated basing on the parameters like biochemical findings and clinical symptoms using IPSS Score, Quality of Life Score, prostate volume using Ultrasound abdomen and pelvis. Our study revealed that, waist circumference, BMI, FBS, Total Cholesterol, HDL cholesterol, LDL cholesterol & HOMA-IR were the significantly associated with the clinical outcome in the MetS +ve patients having BPH. MetS significantly affects the response to medical treatment of BPH as revealed from the IPSS Score, prostate volume and quality of life index. It also emphasizes that MetS evaluation should be an integral part of the standard assessment of male patients with LUTS as well as a new domain in clinical and basic research. Keywords: Metabolic syndrome, Urinary tract, Benign prostatic hyperplasia.

A case series of adrenal lesions in a tertiary care hospital

Introduction: Adrenal lesions as such are very rare conditions, which are incidentally detected through an imaging procedure, performed for reasons unrelated to adrenal dysfunction or suspected dysfunction and are known as adrenal incidentalomas.1 Its prevalence ranges from 1.4% to 2.9% worldwide. We report a series of three cases of adrenal lesions received at our hospital between the years 2011 and 2016. Case series: In a series of three cases, we found that there was one case of Adrenal cortical adenoma, one case of nodular hyperplasia of adrenal gland and one case of adrenocortical carcinoma. Majority of the tumors were seen in the age group of 20-40 years with male preponderance and only 42.8% were detected coincidentally on imaging. Conclusion: The three cases are reported here for their rarity of presentation. Keywords: Adrenal tumours, Adrenal incidentaloma, Adrenocortical carcinomas.

Significance of neutrophil to lymphocyte ratio in prostate lesions with special reference to prostate cancer

Aim: To study the significance of neutrophil- lymphocyte ratio (N:L ratio) in prostate lesions, especially in cases of prostate cancer (PCa). Materials and Methods: Fifty cases of PCa and fifty cases of benign prostatic hyperplasia (BPH), diagnosed on transurethral resection of prostate biopsies were included in the study. Hematological parameters were recorded, N:L ratio was calculated in all cases and values were compared between BPH and PCa, further association between pathological characters of PCa and N:L ratio values was studied. Results: In the present study, we found a statistically significant high N:L ratio in PCa cases as compared with BPH cases (p=0.008). We also found a significant difference in the PSA values (p

Immunohistochemical evaluation of Langerhans cells in oral lichen planus and oral lichenoid lesions

Objectivethe aim of this study was to evaluate the density of Langerhans cells in oral lichen planus (OLP) and oral lichenoid lesions (OLL). Design14 cases of OLP, 15 cases of OLL and 14 cases of oral inflammatory fibrous hyperplasia (OIFH), were selected for immunohistochemical analysis of CD1a, CD207 and S100 expression. The OIFH group was subdivided according to the presence (OIFHL n = 14) or absence (OIFHNL n = 14) of lichenoid inflammatory infiltrate. Positive cells were counted in intraepithelial and subepithelial areas. Results were analyzed by multivariate comparative analysis, correlation analysis, linear regression models and Student’s T-test. ResultsA significantly higher amount of CD207+ cells in OLL vs OLP was observed (p = 0.015). The prevailing reticular pattern observed was CD207high for OLP (p = 0.0329). A statistically significant difference in the expression of CD1a and CD207 was observed for intraepithelial vs subepithelial areas (p = 0.024 and p=0.015, for CD1a and CD207, respectively). Significant correlations were also observed between the expression of CD1a + and CD207+ cells in the pathogenesis of OLP and OLL. ConclusionHigh levels of CD207+cells in OLP compared with OLL may help explain the differences in the immunopathogenesis of both diseases. Additionally, CD1a + and CD207+ cells appear to be more essential to immunopathogenesis of OLL than to the pathogenesis of OLP.

Intravascular papillary endothelial hyperplasia in the oral mucosa and jawbones: A collaborative study of 20 cases and a systematic review.

Intravascular papillary endothelial hyperplasia is an unusual vascular lesion characterized by the proliferation of endothelial cells. The aim of this study was to determine the frequency and general features of this lesion. Biopsy records of three oral pathology services were reviewed for intravascular papillary endothelial hyperplasia cases from 1959 to 2020. In addition, a systematic review of case reports and case series was carried out in eight electronic databases. Of the 65205 retrieved cases, 20 (0.03%) were diagnosed as intravascular papillary endothelial hyperplasia. Mean patient age was 46.55years, and females (12 cases/60%) were more affected. The lower lip (9 cases/47.36%) was the most commonly affected site, and the lesions were generally asymptomatic (7 cases/63.63%). Clinically, 90% of the lesions presented (18 cases) as a nodule, with a mean size of 1.13cm. The clinical diagnostic hypotheses most frequently raised were mucocele (6 cases/37.50%) and hemangioma (5 cases/31.25%). An excisional biopsy was chosen in all cases for treatment. Forty-nine studies of the systematic review were included, yielding 105 cases. The literature showed similarity in all variables. Despite the uncommon frequency, clinicians and oral pathologists should familiarize themselves with the similarities between intravascular papillary endothelial hyperplasia and some other lesions in terms of clinical and histological features.

Clinical and laboratory characteristics of patients with adrenal incidentalomas in the differential diagnosis of subclinical hypercortisolism

Clinical and laboratory characteristics of patients with adrenal incidentalomas in the differential diagnosis of subclinical hypercortisolism. O. E. Tretyak.Purpose. Determination of the prevalence of subclinical Cushing's syndrome among patients with adrenal incidentalomas; determination of the diagnostic consideration of clinical and laboratory parameters used for the diagnosis of endogenous subclinical hypercortisolism.Methods. Retrospective analysis of data from 310 patients, who underwent a surgery for unilateral/bilateral adrenal masses. A comparative analysis of the two groups was carried out; the groups were divided based on the results of postoperative pathohistological study. Group 1 included 244 patients with hormonally active masses - adenomas (210), PBMAH (31), PPNAD (3); Group 2 included 66 patients with inactive masses. There were assessed the prevalence of hypertension, DM 2, overweight and the results of laboratory studies of the cortisol level after dexamethasone suppressive test, ACTH, and daily urine-free cortisol excretion.Results. Patients with hormonally active masses are older (mean age is 52.7 years); 68.4% of patients in group 1 haveAH, 27% haveDM2 (group 2, respectively, 36.4% and 13.6%). There are no differences between groups as to the presence of overweight and obesity. 22.5% of patients of group 1 were confirmed to havePA, in most cases against the background of bilateral masses. The parameter of cortisol after DST has the best diagnostic consideration – sensitivity 90.2%, specificity 74% at a cut-off point level of 1.7 μcg/dL; for ACTH &lt;10 pg/mL, the sensitivity is 71.4% and the specificity is 92.6%. Daily cortisol urine-free excretion has the third most significant diagnostic consideration (sensitivity 71.4%, specificity 81.8%, COP 238 mg/24 h.), which limits the application of this parameter for the confirmation of high levels of cortisol in patients with incidentalomas. Cases of bilateral adrenal hyperplasia should be considered as a probable variant of PBMAH syndrome, requiring further laboratory testing for PA.

Embolization of a rare case of focal nodular hyperplasia in an adolescent boy

This report highlights a special case of focal nodular hyperplasia (FNH) in a 14-year-old boy. FNH is a benign liver lesion which typically presents in middle-aged women. Symptomatic FNH lesions, lesions of large size, or lesions in problematic locations are often surgically resected. Surgical treatment options such as resection or liver transplantation were discussed in our case, however the mass was deemed unresectable due to its central location and proximity to vascular structures. Super-selective particle embolization of this hypervascular benign mass proved to be an effective treatment resulting in complete resolution of symptoms and significant reduction of the size of the mass, with no post-procedural complications.

肺癌との鑑別を要した結節性リンパ組織過形成（NLH）の1例

肺癌との鑑別を要した結節性リンパ組織過形成（NLH）の1例