RESUMO
A 24-year-old woman with non-pituitary dependent Cushing's syndrome was found to have bilateral adrenal myelolipomas at surgery. These benign tumors consist of bone marrow and fat and are uncommon incidental findings that are discovered by computed tomography. Myelolipomas have rarely been associated with Cushing's syndrome, but the cause of the syndrome has not always been defined, because the reports preceded modern diagnostic methods. Careful examination of the adrenal glands from our patient showed a fusion of myelolipoma elements and adrenal cells without distinct adenomas or the typical nodular pattern of adrenal hyperplasia. This report suggests that adrenal myelolipomas and atypical hyperplasia of the zona fasciculata may be anatomically and functionally related.
Assuntos
Neoplasias das Glândulas Suprarrenais/complicações , Síndrome de Cushing/complicações , Lipomatose/complicações , Neoplasias das Glândulas Suprarrenais/diagnóstico por imagem , Neoplasias das Glândulas Suprarrenais/patologia , Adrenalectomia , Hormônio Adrenocorticotrópico/metabolismo , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Lipomatose/diagnóstico por imagem , Lipomatose/patologia , Tomografia Computadorizada por Raios XAssuntos
Bancos de Sangue/normas , Transfusão de Sangue/normas , Coleta de Amostras Sanguíneas/métodos , Coleta de Amostras Sanguíneas/normas , Transfusão de Sangue/métodos , Transfusão de Sangue Autóloga/métodos , Transfusão de Eritrócitos , Humanos , Transfusão de Leucócitos , Transfusão de PlaquetasRESUMO
An association between atherosclerosis, biliary obstruction and hyperlipidemia has been reported in the literature. In previous study from this laboratory, ultrastructural evidence of coronary artery endothelial damage was obtained in rats following ligation-induced biliary obstruction. In the present investigation, serum bile acids, total cholesterol and alkaline phosphatase levels were studied in association with similarly induced biliary obstruction and related to electron-microscopic observations of coronary artery endothelium. The results disclosed marked elevation of all serum parameters in as short a time as 24 hr following ligation compared with shamoperated controls. Animals exhibiting increases of serum bile acids and cholesterol also revealed severe configurational changes of endothelial cells which manifesed as buckling, detachment from the underlying internal elastic lamina, and vacuole formation. The role of elevated circulating bile acids and hypercholesterolemia as possible factors in producing arterial injury through membrane interaction is discussed. These observations suggest that biliary obstruction, even of short duration, may act as a potentially atherogenic mechanism in the experimental animal.
