Endocrine-related injuries associated with immune checkpoint inhibitors: what endocrinologists and oncologists should know / 中华内分泌代谢杂志

The development of medications known as immune checkpoint inhibitors(ICPis) has been a milestone of cancer therapy. However, the increasing use of ICPis in recent years has caused a diverse spectrum of immune-related adverse events, including endocrine glands injury. ICPis-induced endocrinopathies are new challenges brought by advances of medicine as well as become the hot topics in both endocrinology and oncology. It is important that endocrinologists and oncologists should know how to perform proper assessment and clinical management once ICPis-induced endocrinopathies occur. Interdisciplinary collaboration is required to deal with this medical problem in order to improve overall survival and quality of life for patients with various cancer.

Study of the expression of endocrine gland-derived vascular endothelial growth factor in the spinal cord tumors / 中国基层医药

Objective To explore the relationship of spinal tumors and endocrine gland-derived vascular endothelial growth factor( EG-VEGF) .Methods 77 cases of spinal tumors and 17 cases of vertebral compression fractures were collected.The testing group were grouped according to the pathological type of spinal tumor,the observ-ing group was consisted of vertebral compression fracture cases.The samples of various types of tumors in patients were collected during operation and the positive rate and expression of EG-VEGF mRNA were detected by RT-PCR technique,and the results of each group were statistical analysed.Results The results of relative expression of EG-VEGF mRNA in the unknown primary spinal metastases group,osteosarcoma group and chordoma group were higher, there were no statistically significant difference compared between three groups(all P>0.05).Relative expressions of that in osteoid osteoma group and giant cell tumor group were lower,so was in the observation group,there were no sig-nificant differences in three groups ( all P>0.05);The relative expressions of EG-VEGF mRNA in CUP group, osteosarcoma group and chordoma group were significantly higher than the osteoid osteoma group,with statistical sig-nificance[(0.81 ±0.21),(0.84 ±0.22),(0.79 ±0.41)vs(0.53 ±0.19),t=0.86,0.82,0.81,all P<0.05]. Similar results were also found in EG -VEGF mRNA positive expression rate in three groups.Conclusion EG-VEGF in normal spine spinal vertebrae and primary benign tumor ( osteoid osteoma,giant cell tumor) showed lower expression,which consistent with its tissue specificity,but in primary malignant spinal cancer ( osteosarcoma, chordoma) and unknown primary tumor spinal metastases showed the higher expression, indicating that it may be a measure of an important indicator of spinal cancer, and may play a key role in early diagnosis and treatment of cancer of the spine in the future.

Pancreatic cell apoptosis and endocrine alterations in rats with acute obstructive pancreatitis / 中华胰腺病杂志

Objective To investigate the occurrence of apoptosis and its relationship with endocrine hormones altemtions in rats with acute obstructive pancreatitis(AOP). Methods The model of AOP wag establisbed by ligation of pancreaticobiliary duct.8,12 hrs after operation,the serum insulin,glucagons and amvlase were determined;pancreatic tissues were harvested and apoptotic rate wag evaluated by TUNEL and flow cytometry(Annexin V-FITC/PI assay).Results 8 and 12 hrs after AOP induction,serum amylase levels wefe(1198±687)U/L and(1698±1103)U/L respectively;serum insulin levels were(8.1±5.8)ng/ml and (12.7 ±6.9)ng/ml respectively;sertlm glucagon levels were(6.8±4.6)ng/ml and(7.3±2.9)ng/ml respectively;all these parameters were significantly high than(404±222)U/L,(5.6±2.7)ng/ml and(2.6±2.1)ng/ml in the sham operation group(P<0.05).AnnemnV FITC/PI assay confirmed apoptosis occurred both in exocrine acinus cells and endocrine panclreas islet;and the apoptotic rate wag(20.5±11.2)%and (15.5±8.9)%at 8 and 12 hrs after AOP induction,which wag significantly high than(4.2±1.6)%in the sham operation group(P<0.05).Conclusions Cell apoptosis occurred in both acinar and islet in the model of AOP,and this may be the pathophysiological basis of endocnne hormones alterations in the model of AOP.

Leiomiossarcoma primário de adrenal / Primary adrenal leiomyosarcoma

O leiomiossarcoma da glândula adrenal é uma neoplasia extremamente rara, cuja origem provém da veia central da adrenal ou de suas tributárias. Estes tumores são vistos com incidência aumentada em pacientes infectados pelo vírus da imunodeficiência humana adquirida (HIV) e também pelo vírus Epstein-Barr (EBV). Relata-se o caso de uma paciente de 48 anos diagnosticada, por meio de exames de imagem, massa ocupando loja adrenal esquerda, próxima ao pâncreas. Foi submetida à ressecção cirúrgica com achados histopatológicos e imunohistoquímico compatíveis com leiomiossarcoma primário de adrenal. A paciente foi a óbito após 53 meses da adrenalectomia. Concluiu-se que, não obstante a raridade desta neoplasia, sabe-se que, bem como os demais sarcomas de partes moles, o leiomiossarcoma de adrenal se comporta de maneira agressiva e tem na adrenalectomia o tratamento de escolha, não sendo necessário o emprego de quimio ou radioterapias de rotina, exceto em doença metastática ou irressecável.

Leiomyosarcoma of adrenal gland is an extremely rare tumor originating from the central adrenal vein or its tributaries. Patients with human immunodeficiency virus (HIV) and Epstein-Barr infection have a higher incidence of these tumors, but even in those, the overall incidence is very low. In this paper we report a case of a 48 year-old woman whose diagnosis was made by image exams that had suggested a mass in adrenal area. This patient was submitted to surgery for resection of the mass. The histopathologic and immunohistochemistry exams were compatible with primary leiomyosarcoma of adrenal gland. Fifty-three months after adrenalectomy the patient died with recurrent disease. Despite of the rarity of this tumor, leiomyosarcoma of adrenal gland has an aggressive behavior, such as the others soft tissue sarcomas. The adrenalectomy is the primary treatment, while chemotherapy or radiotherapy is not prescribed except in metastatic or bulky and not operative disease.

Ultrasonographic and CT findings of Cervical Ectopic Thymus of an Infant

We report a case of ectopic thymus in the left submandibular area of a two-month-old boy. On US and CT scans, a well-marginated, 3 x 2cm-sized solid mass along the left carotid sheath, anteromedial to the sternocleidomastoid muscle and posterior to the submandibular gland, was seen. CT attenuation of the mass showed that it was similar to that of normal thymus in the anterior mediastinum. Although a rare disease, ectopic thymus should be included in the differential diagnosis of cervical masses along the carotid sheath in infants.

Ultrasonographic Analysis of Normal Thymus in Infants

PURPOSE: To analyse the ultrasonographic findings of normal thymus in infants and determine the pathologic findings. MATERIALS AND METHODS: Forty two infants without a history of chronic disease, tumor or steroid therapy were scanned in the axial planes with a 7.0 MHz sector transducer. Bilaterality, homogeneity, and the shape and intensity of thymic echogenicity were analysed; shapes were classified as one of three types, namely bilobate, quadrangular or triangular. The intensities of thymic echogenicity were compared with those of the liver and spleen under the same conditions (time-gain compensation, depth and gain). RESULTS: Bilaterality was seen in 36 cases, homogeneity in 35, homogeneity and bilaterality in 29, inhomogeneity and bilaterality in seven, and homogeneity and unilaterality in six. No case showed inhomogeneity and unilaterality. The shape was bilobate in 23 case, quadrangular in 13 and triangular in six, while the outer border was convex in 29 cases and straight in 13. In no case was echogenicity of the thymus greater than that of the liver or spleen. Transverse diameters were 21-47mm (mean, 37.0mm; SD, 9.4mm) and depths were 10-37.5mm (mean, 25.8mm; SD, 5.9mm). CONCLUSION: The usual findings of normal thymus in infants are bilaterality and homogeneity, convex or shaight outer border, and echointensity less than or equal to that of the liver and spleen. The possibility of thymic pathology is suggested when ultrasonography shows unilaterality, inhomogeneous echogenicity, and echogenicity greater than that of the liver and spleen.