Sutherlandmejer2802

Although histopathology remains in the first line of the diagnosis of pituitary pathology, immunohistochemistry and molecular biology are currently in charge of providing a more accurate characterisation of tumours in this field.

A systematic review of the literature was performed, using the PubMed and SCOPUS databases, with terms that included transcription factors involved in the development of pituitary tumours T-PIT, PIT-1, and SF-1.

The results showed different perspectives, but the evidence is in favour of a multifold immunohistochemical analysis that must include pituitary transcription factors for a highly accurate diagnosis, prognosis, and guidance of (multimodal) therapy.

By using transcription factors, the understanding of the structure and function of the recently defined pituitary neuroendocrine tumours has made significant progress. This approach brings the (sub)classification of pituitary tumours, using cell types and cell lineages, with clinical and molecular implications and therapeutic results.

By using transcription factors, the understanding of the structure and function of the recently defined pituitary neuroendocrine tumours has made significant progress. This approach brings the (sub)classification of pituitary tumours, using cell types and cell lineages, with clinical and molecular implications and therapeutic results.Introduction Somatostatin analogues are a cornerstone in the treatment of acromegaly. Somatostatin analogues of the first generation, mainly targeting the somatostatin receptor (SSTR) subtype 2, proofed to be efficient in most patients with acromegaly. With the development of somatostatin analogues targeting the subtype 5 additionally to the subtype 2, i.e. pasireotide, an efficient drug for ACTH secreting pituitary tumors and suboptimal responding acromegaly patients became available. Methods We investigated immunohistochemically SSTR subtypes expression in three pituitary adenomas two from operated acromegaly patients with clinical relapse and one from a patient with clinically silent ACTH-positive macroadenoma with unfavourable clinical course. Results The predictive value of SSTR subtypes immunhistochemical analysis for the therapeutic response was discussed. The one silent corticotroph adenoma case presented here was negative for subtype 2 as well as for subtype 5 and therefore we did not see an indication for somatostatin analogue therapy. In acromegaly high Ki-67 appeared to have a negative impact upon therapeutic response in the two cases. Conclusion The immunohistochemical analysis of SSTR subtypes expression in pituitary adenoma patients especially with acromegaly and complicated clinical course might be helpful for decision making or prognostic significance. Our case reports point to the need of clinical trials for further investigation.Burkitt lymphoma (BL) of the thyroid gland is an aggressive and very rare B cell non-Hodgkin lymphoma (NHL). A 28-year-old female was admitted to our clinic with a visible swelling on the right side of the neck. Ultrasonography was performed and revealed a mass of 1.5 x 1cm in the lower pole of the right lobe of the thyroid. Fine needle aspiration cytology of the mass was done and was suspicious of NHL. The patient underwent right thyroid lobectomy with isthmusectomy, as the likelihood of other types of thyroid cancer could not be excluded. However, pathological exam after surgery was negative for malignancy. this website The diagnosis was confirmed by the second biopsy. BL of the thyroid gland is an aggressive and very rare NHL and accurate diagnosis is critical for the assessment of the stage of the disease, and the selection of the appropriate therapy.Not required for Clinical Vignette.Opisujemy przypadek pacjentki z rozpoznaniem raka neuroendokrynnego trzustki z przerzutem do skóry. Pierwotnie, w badaniu fizykalnym stwierdzono jedynie powiększone węzły chłonne pachwinowe prawe. Pomimo wykonania wielu badań obrazowych i czynnościowych oraz przeprowadzenia licznych konsultacji specjalistycznych nie zlokalizowano ogniska pierwotnego. W wykonanych, w przebiegu choroby, kontrolnych badaniach obrazowych uwidoczniono ognisko pierwotne w trzustce. Pacjentkę zakwalifikowano do zabiegu resekcyjnego. Jednak przed planowanym zabiegiem pacjentka zauważyła szybkorosnącego guza przedramienia, który w badaniu histopatologicznym okazał się przerzutem raka neuroendokrynnego do skóry. Z powodu znacznej progresji guza trzustki odstąpiono od zabiegu operacyjnego. Pacjentkę skierowano do paliatywnego leczenia onkologicznego, którego ze względu na gwałtownie pogarszający się stan ogólny nie otrzymała. Zmarła po 6 miesiącach.Not required for Clinical Vignette.

The Bethesda classification system for reporting thyroid cytopathology is the standard for interpreting fine needle aspirate (FNA). Because of its heterogeneity and inconsistent reporting, atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS), known as Bethesda category III, is the most controversial category. Thyroid nodules that fall within Bethesda categories III-IV have an overall risk of malignancy of between 15 and 40%. The aim of this study was to determine the malignancy rate in Bethesda III nodules.

A retrospective study was performed for 1166 patients who underwent thyroid surgery for multinodular goitre (MNG) or solitary nodular goitre (SNG) in our institution between June 2010 and May 2020. Data retrieved included demographic characteristics of the patients, FNB cytology, thyroid function test results, type of thyroidectomy, and final histology results.

During the study period, 29.5% (344/1166) of patients with an FNA categorized as AUS/FLUS underwent thyroid surgery. Of these 344 patients, 190 were diagnosed with MNG and 154 with SNG. Incidental malignancy was found in 35 of 190 cases of MNG (18.42%) and 31 of 154 cases of SNG (20.13%). The most common malignant tumour type in either category was the follicular variant of papillary thyroid carcinoma.

The current study demonstrates that patients with a FNA categorized as AUS/FLUS may have a higher risk of malignancy than traditionally believed. Reconsideration may be necessary to guidelines that recommend observation or repeat FNA in this category of patients.

The current study demonstrates that patients with a FNA categorized as AUS/FLUS may have a higher risk of malignancy than traditionally believed. Reconsideration may be necessary to guidelines that recommend observation or repeat FNA in this category of patients.