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Objective: Localization of microadenomas in Cushing ' s disease may be difficult as in up to 45 % of patients sellar MRI fails to detect a pituitary tumor. Intraoperative transsphenoidal ultrasound may identify microadenomas as hyperechoic structures. We report on the first 18 consecutive cases with intraoperative use of a new device for direct contact high-frequency-ultrasound in patients with Cushing ' s disease. Patients and technique: 18 patients (14 female, 4 male, age 24 - 71 years) with typical endocrinological findings for Cushing ' s disease were included in the study. One macroadenoma and 13 microadenomas were suspected or identified preoperatively by MRI. In 4 cases, two of them with recurrent disease, sellar MRIs were negative. During transsphenoidal microsurgery an end fire ultrasound-probe (B-mode frequency range 7.5 - 13 Mhz, field of view 5 mm, penetration 20 mm) was introduced after opening of sellar floor. The pituitary gland was scanned in direct contact to the capsule. Results: In 13 out of 17 cases (77 % ) with later on proven microadenomas high-frequencyultrasound identified the tumors as hyperechoic masses, including 3 of the 4 cases with negative preoperative MRI. In 2 cases ultrasound correctly localized the tumor at a site different from MRI finding (MRI false positive). In the macroadenoma, identification of the border between tumor and anterior pituitary gland was not possible. In all 18 patients postoperative early decline of serum cortisol to subnormal levels confirmed remission of hypercortisolism (100 % ). Other pituitary functions were unaltered in 17 cases (94 % ). Conclusions: Intraoperative scanning of the pituitary gland with high-frequency-ultrasound probes may identify intrapituitary anatomy andpathologies even in MRI-negative cases. This may prevent extensive exploration of the gland with the risk of subsequent hypopituitarism. [ABSTRACT FROM AUTHOR]

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Copyright of Rechtsmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Rechtsmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study provides a base for evaluating incidentalomas. The incidence and type of pathological findings in a large group of surgically removed adrenal glands were analyzed: 282 resected adrenals from the years 1995 to 2004 were examined; 242 adrenals were removed for therapy of renal cell carcinomas (in one case both adrenals were removed). Other indications for adrenalectomies were malignant tumors (urothelial carcinoma, squamous cell carcinoma, sarcoma, lymphoma, etc.) and benign findings (oncocytoma, angiomyolipoma, pyelonephritis, etc.). A total of 18 adrenals exhibited a metastasis or diffuse infiltration of the adrenal or para-adrenal tissue by a malignant tumor (17 renal cell carcinomas, 1 non-Hodgkin's lymphoma). Seven adrenals exhibited an adenoma. Eighty-nine adrenal hyperplasias were diagnosed. Eighty-six adrenals included myelolipomatous or lipomatous foci. One hundred and thirteen adrenals (40.1%) did not exhibit any pathological findings. The adrenals exhibited infiltration or metastasis by malignant tumors (6.4%), adrenal adenomas (2.5%), adrenal hyperplasias (31.6%), and other alterations (38.7%). [ABSTRACT FROM AUTHOR]

A case of a 70-year-old man presenting with exsudative enteropathy due to light-chain-associated amyloidosis is reported. The diagnosis of systemic mastocytosis associated with IgG/λ plasma cell myeloma and secondary generalised amyloidosis was carried out by morphological evaluation of bone marrow biopsy. The c-kit point mutation D816Y was detected by molecular analysis. Two years before, a cystadenolymphoma of the left parotid gland had been removed. A moderate increase of loosely scattered spindle- shaped mast cells, a subpopulation of them expressing CD25, an antigen that is not expressed by normal or reactive mast cells, was shown by retrospective analysis carried out on art intraparotideal lymph node. The c-kit mutation D816Y was shown by the molecular analysis of the lymph node. In summary, the notion that systemic mastocytosis may very rarely be associated with B cell neoplasms and that neoplastic mast cell infiltrates may be obscured because of only a minimal increase of atypical mast cells, which are outnumbered by other non-neoplastic cells in the same tissue, is supported by this case. This finding was preliminarily termed ‘occult’ mastocytosis. [ABSTRACT FROM AUTHOR]

Copyright of Der Pathologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Pathologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)