Limfocytarne zapalenie przysadki: zbyt rzadko rozpoznawana choroba okolicy siodła tureckiego

Hypophysitis is an inflammation of the pituitary gland and includes a heterogeneous group of diseases presenting with impaired pituitary gland function. Hundreds of cases have been reported after Goudie and Pinkerton's initial report on a young postpartum woman who died after progressive lymphocytic infiltration of the adenohypophysis in 1962. A 17-year-old woman presented with a three-year history of headache, galactorrhoea and excessive weight gain. The patient had used oral contraceptives for several years until one year previously. Her examination demonstrated only bilateral heteronymous hemianopsia. Laboratory investigation revealed elevated prolactin and decreased gonadotropin levels. Magnetic resonance imaging showed a sellar mass with suprasellar extension. Surgical removal of the lesion was performed via a transsphenoidal approach. A diagnosis of lymphocytic hypophysitis was confirmed by histopathological evaluation. Hypophysitis is an underestimated disease affecting the pituitary gland. Cases are usually diagnosed as adenomas and treated with surgical removal. This case is presented due to the extremely rare infiltration of the pituitary gland by predominantly lymphocytes.Zapalenia przysadki to niejednorodna grupa chorób manifestujących się zaburzoną czynnością przysadki. Od opublikowanego przez Goudiego i Pinkertona w 1962 r. opisu młodej kobiety, która zmarła po porodzie i u której stwierdzono limfocytarny naciek przedniego płata przysadki, opublikowano setki takich przypadków. Siedemnastoletnia kobieta zgłosiła się z powodu utrzymujących się od trzech lat bólów głowy, mlekotoku i zwiększenia masy ciała. Przez kilka lat, aż do roku poprzedzającego zgłoszenie do lekarza, stosowała hormonalne środki antykoncepcyjne. W badaniu przedmiotowym stwierdzono jedynie obustronne różnoimienne niedowidzenie połowicze. W badaniach laboratoryjnych wykryto zwiększone stężenie prolaktyny i zmniejszone stężenia gonadotropin. W badaniu za pomocą rezonansu magnetycznego uwidoczniono guz siodła tureckiego wychodzący poza obręb siodła. Zmianę usunięto chirurgicznie z dostępu przezklinowego. W badaniu histopatologicznym potwierdzono rozpoznanie limfocytarnego zapalenia przysadki. Zapalenie przysadki jest chorobą rozpoznawaną zbyt rzadko. U chorych rozpoznaje się zwykle gruczolaki i leczy się je chirurgicznie. Przypadek przedstawiono ze względu na wyjątkowo rzadko spotykany naciek przysadki, w którym dominowały limfocyty

Comparison of ultrasound, mammography and histopathology findings of the cases with gynecomastia

Background: Gynecomastia is the development of a fibroepithelial structure in the male breast as a result of many benign and malignant effects. In this study, after the confirmation of gynecomastia diagnosis in the male cases with swelling, mass and tenderness in the breast using ultrasound and mammography examinations, its etiology was clarified by laboratory tests. In case of suspicion, the diagnosis was confirmed using Fine-Needle Aspiration Biopsy (FNAB). The adequacy of ultrasound and mammography was discussed with the obtained information and the information in the literature, and the etiological and radiological classification was done.Methods: Ultrasound and mammography examinations were performed on 74 male patients with growth, palpable masses or pain in the breast. Biochemistry and hormone analysis were performed with imaging methods in the cases of possible gynecomastia. Biopsy was performed on the cases with the suspicion.Results: Gynecomastia were divided into three types in ultrasonic and mammographic examination. The most frequent gynecomastia was observed as Type 3 (51.43%) in ultrasonic examination and as diffuse type (61.42%) in mammographic examination. Pain and tenderness accompanied with swelling at the breast were present in 37.84% of the cases. 31.42% had pubertal gynecomastia, 25.71% had gynecomastia secondary to drug use, and 15% had idiopathic gynecomastia.Conclusions: Combined use of ultrasound and mammography in the diagnosis and classification of gynecomastia is highly sufficient and biopsy should be performed if malignancy is suspected.

Squamous Cell Carcinoma Differentiation of Ovarian Mature Cystic Teratoma in a Postmenopausal Woman Presented As Acute Abdomen

To emphasis that, although it is rare, the mature cystic teratomas can transform to malignancy and can be cause of acute abdomen. A 61 year old postmenopausal woman who had been operated because of acute abdomen and adnexal mass and the pathologic result was reported as squamous cell carcinoma differentiated from mature cystic teratoma. It has to be keep in mind, due to the compounds of mature cystic teratomas, they are tend to torsion, can be cause of acute abdomen and rarely, malignant differentiation can be seen

A case report: paratesticular rhabdomyosarcoma

Intrascrotal diagnosed masses are often localized to testicle. Others located in extratesticular areas mostly ariss from paratesticular tissues. It accounts for approximately 1%-2% of all pediatric solid masses and incidence is about 0,5-2 among 100000 patients (1). Paratesticular rhabdomyosarcomas, which are rarely seen malignant tumors arises in the mesenchymal tissue of the spermatic cord and are responsible from 75% of all rhabdomyosarcoma cases, and also 17% of pediatric malignant intrascrotal tumors (2). In this report, we reviewed a patient presented with a scrotal swelling and diagnosed as paratesticular rhabdomyosarcoma after radical orchiectomy

A Huge Cemento-Ossifying Fibroma of Paranasal Sinus: A Case Report

Cemento-ossifying fibroma is a well-bordered, slow-growing, benign fibro-osseous disease. Although its localization is generally in the mandible, it can be seen in any area of the craniofacial region. Radiology and histopathology help to diagnose the condition. Treatment is based on close observation and/or surgical excision. In this case, we report the case of a 62-year-old male patient who had a large radiological appearance, cemento-ossifying fibroma in the paranasal sinuses

Vulvar syringomas as a part of nonfamilial generalized eruptive form: Unusual lesions leading to pseudohyper-trophy of the labia majora

We present a case of eruptive generalized syringoma with vulvar involvement. This case is unique in terms of being a nonfamilial, linear variant, leading to pseudohypertrophy of the labia majora

Endoscopic and histopathological evaluation of acute gastric injury in high-dose acetaminophen and nonsteroidal anti-inflammatory drug ingestion with suicidal intent

AIM: To evaluate endoscopic and histopathologic aspects of acute gastric injury due to ingestion of high-dose acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) with respect to some risk factors and patient characteristics

N-terminal pro-B-type natriuretic peptide as a marker of blunt cardiac contusion in trauma

Cardiac contusion is usually caused by blunt chest trauma and, although it is potentially a life-threatening condition, the diagnosis of a myocardial contusion is difficult because of non-specific symptoms and the lack of an ideal test to detect myocardial damage. Cardiac enzymes, such as creatine kinase (CK), creatine kinase MB fraction (CK-MB), cardiac troponin I (cTn-I), and cardiac troponin T (cTn-T) were used in previous studies to demonstrate the blunt cardiac contusion (BCC). Each of these diagnostic tests alone is not effective for diagnosis of BCC. The aim of this study was to investigate the serum heart-type fatty acid binding protein (h-FABP), N-terminal pro-B-type natriuretic peptide (NT-proBNP), CK, CK-MB, and cTn-I levels as a marker of BCC in blunt chest trauma in rats. The eighteen Wistar albino rats were randomly allocated to two groups; group I (control) (n=8) and group II (blunt chest trauma) (n=10). Isolated BCC was induced by the method described by Raghavendran et al. (2005). All rats were observed in their cages and blood samples were collected after five hours of trauma for the analysis of serum hFABP, NT-pro BNP, CK, CK-MB, and cTn-I levels. The mean serum NT-pro BNP was significantly different between group I and II (10.3 +/- 2.10 ng/L versus 15.4 +/- 3.68 ng/L, respectively; P=0.0001). NT-pro BNP level >13 ng/ml had a sensitivity of 87.5%, a specificity of 70%, a positive predictive value of 70%, and a negative predictive value of 87.5% for predicting blunt chest trauma (area under curve was 0.794 and P=0.037). There was no significant difference between two groups in serum h-FABP, CK, CK-MB and c Tn-I levels. A relation between NT-Pro BNP and BCC was shown in this study. Serum NT-proBNP levels significantly increased with BCC after 5 hours of the blunt chest trauma. The use of NT-proBNP as an adjunct to other diagnostic tests, such as troponins, electrocardiography (ECG), chest x-ray and echocardiogram may be beneficial for diagnosis of BCC