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A diffuse increase in mesangial matrix along with mesangial cell proliferation and is always associated with basement membrane thickening of the glomerulus. Seen in patients with diabetic nephropathy.

Diffuse mesangial sclerosis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 783


A glomerular lesion made distinctive by ball-like deposits of a laminated matrix situated in the periphery of the glomerulus. Seen in diabetic nephropathy.

Nodular glomerulosclerosis. SEE SLIDE 20.12. (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 783


A special pattern of acute pyelonephritis seen more often in diabetics.

Necrotizing papillitis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 784


Most common pancreatic endocrine neoplasms.

beta-cell tumors (insulinomas) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 788


These benign tumors look remarkably like giant islets, with preservation of the regular cords of monotonous cells and their orientation to the vasculature. Also has amyloid deposition in the extracellular tissue. SEE SLIDE 20.13.

Insulinomas (TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 751


What syndrome is described by the association of pancreatic islet cell lesions with hypersecretion of gastric acid and severe peptic ulceration?

Zollinger-Ellison syndrome(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 788


Tumors associated with increased serum glucagon and a syndrome consisting of mild diabetes mellitus, a characteristic skin rash (necrolytic migratory erythema), and anemia. SEE SLIDE 20.14.

Alpha-Cell tumors (glucagonomas) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 789


Most common cause of Cushing syndrome.

Administration of exogenous glucocorticoids(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 789


Primary hypothalamic-pituitary disease associated with oversecretion of ACTH. The adrenal glands characterized by variable degrees of bilateral nodular cortical hyperplasia.

Cushing disease(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 789


In this condition, the normal granular, basophilic cytoplasm of the ACTH-producing cells in the anterior pituitary is replaced by homogeneous, lightly basophilic material. This results from high levels of endogenous or exogenous glucocorticoids.

Crooke hyaline change. SEE SLIDE 20.15. (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 790


Lung cancer associated with a paraneoplastic syndrome leading to excessive production of ACTH.

Small-cell lung cancer(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 792


Caused either by an aldosterone-producing adrenocortical neoplasm, usually an adenoma, or by primary adrenocortical hyperplasia, resulting in suppression of the renin-angiotensin system and decreased plasma renin activity.

Primary hyperaldosteronism/ Conn syndrome(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 792


A characteristic feature of aldesterone-producing adenomas which is the presence of eosinophilic, laminated cytoplasmic inclusions. These are typically found after treatment with the anti-hypertensive drug which is the DOC for primary hyperaldosteronism. SEE SLIDE 20.16.

Spironolactone bodies(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 792


The adrenals are hyperplastic bilaterally, sometimes expanding to 10 to 15 times their normal weights,due to sustained elevation in ACTH. The adrenal cortex is thickened and nodular, and on cut section, the widened cortex appears brown as a result of depletion of all lipid

Congenital adrenal hyperplasia(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 793


Acute adrenal insufficiency caused by severe bilateral adrenal hemorrhage in an infant with overwhelming sepsis. The adrenals are grossly hemorrhagic and shrunken; microscopically, little residual cortical architecture is discernible

Waterhouse-Friderichsen syndrome(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 794


An uncommon disorder resulting from progressive destruction of the adrenal cortex. May be due to autoimmune adrenalitis, tuberculosis, AIDS, or metastatic cancers.

Addison disease/ chronic adrenocortical insufficiency(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 794


The adrenals are reduced to small, flattened structures that usually retain their yellow color because of a small amount of residual lipid. Histologically, there is atrophy of cortical cells with loss of cytoplasmic lipid, particularly in the zonae fasciculata and reticularis, due to decreased ACTH stimulation.

Secondary hypoadrenalism (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 795


Characterized by irregularly shrunken glands, which may be exceedingly difficult to identify within the suprarenal adipose tissue. Histologically, the cortex contains only scattered residual cortical cells in a collapsed network of connective tissue.

Primary autoimmune adrenalitis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 795


Neoplasms composed of chromaffin cells which synthesize and release catecholamines and other peptide hormones. Composed of polygonal to spindle-shaped chromaffin cells compartmentalized into nests, or "Zellballen," by a rich vascular network. SEE SLIDE 20.17.

Pheochromocytomas(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 797


Most common extra-cranial solid tumor of childhood. Occur most commonly during the first 5 years of life and may arise during infancy.

Neuroblastoma (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 798


Components of MEN1?

Parathyroid: Primary hyperparathyroidismPancreas: ZES, insulinoma, etc.Pituitary: prolactin-secreting macroadenoma, somatotrophin-secreting tumors(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 798


Components of MEN2A?

Thyroid: Medullary carcinomaAdrenal medulla: pheochromocytomasParathyroid: parathyroid gland hyperplasia (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 799


Components of MEN2B?

Thyroid: Medullary carcinomaAdrenal medulla: pheochromocytomaExtraendocrine manifestations: ganglioneuromas of mucosal sites (gastrointestinal tract, lips, tongue) and marfanoid habitus (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 799


All individuals carrying germ-line RET mutations are advised to undergo prophylactic thyroidectomy to prevent the development of what type of carcinoma?

Medullary Carcinoma (TOPNOTCH)


What is the most common site of gastrinomas in individuals with MEN-1?

Duodenum (TOPNOTCH)


What is the most frequent anterior pituitary tumor encountered in individuals with MEN-1?

Prolactinoma (TOPNOTCH)


What is the most common cause of primary adrenal insufficiency in developed countries?

Autoimmune adrenalitis (TOPNOTCH)


Spirinolactone bodies are seen in what tumor? SEE SLIDE 20.16

Aldosterone producing adenomas (TOPNOTCH)


Crooke hyaline change is seen in? SEE SLIDE 20.15

Cushing syndrome (TOPNOTCH)


Watery Diarrhea, hypokalemia, achlorhydria or WDHA syndrome is seen in?