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Query: UMLS:C0002453 (amenorrhea)
 6,245 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A sub-capsular haematoma of the liver is a rare but very serious complication of pregnancy. We report a case of a primipara whose pregnancy was first complicated by hypertension, then by a haematoma of the liver at the 28th week of amenorrhoea. It was diagnosed because of the clinical symptoms associated with the hypertension and a pain in the right hypochondrium and nausea. The diagnosis of haematoma of the liver was made before rupture and confirmed by ultrasound of the liver and by tomodensitometry made it possible to avoid operating on the liver during the laparotomy that was carried out to terminate the pregnancy. Regular X-ray follow-ups showed that the lesion had regressed in six months. MRI investigation of the parenchyma of the liver showed no cause of the lesions. If there is even the slightest suspicion of a haematoma of the liver in pregnancy, ultrasound nowadays should be carried out because it is indispensable to make the diagnosis.
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PMID:[Sub-capsular hematoma of the liver during pregnancy: a case report]. 149 Nov 44

The authors reported a rare case of sellar germinoma which was misdiagnosed as nonfunctioning pituitary adenoma. A 32-year-old woman was admitted to our hospital because of amenorrhea and disturbance of left visual acuity. She had become amenorrhagic after her second delivery two years before. Neurological examination revealed she was normal except for diminished left visual acuity (Rt. = 1.2, Lt. = 0.5). The general condition was good. Urine volume and its specific gravity were within normal range. Endocrinological examination showed hyperprolactinemia (PRL 72 ng/ml) accompanied with impairment of GH, TSH, LH and FSH's reserve. Basal levels and reserve of the blood cortisol were normal. AFP and hCG were within normal range. CT scan revealed a homogenously enhanced intrasellar tumor which had a suprasellar portion (vertical length: 15 mm). T1 weighted MRI revealed low intensity tumor, and T2 weighted image revealed high intensity tumor. Sagittal MR image with gadolinium enhancement showed the pituitary gland anterior to the tumor. Transsphenoidal removal was performed. The histological diagnosis was pure germinoma. After the operation, the intracranial and spinal disseminations were disclosed. Complete neuraxis irradiation resulted in the complete remission of the tumor. Sellar germinoma without diabetes insipidus is considered to be very difficult to diagnose preoperatively. However, the authors proposed that anterior shift of the pituitary gland in sagittal MR image may be a clue to the diagnosis of sellar germinoma.
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PMID:[A case of sellar germinoma which was misdiagnosed as pituitary adenoma]. 176 58

The authors report a case of twins conjoined at the umbilicus and diagnosed by ultrasound after 19 weeks of amenorrhoea in whom an assessment in utero was carried out using magnetic resonance imaging after the patient had been curarized. A review of the literature on this very difficult problem of conjoined twins has given us the possibility to assess the diagnostic measures as well as the prognosis of this pathology. In particular we point out the results that can be obtained using MRI in utero during the second and third trimesters of the pregnancy.
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PMID:[Magnetic resonance imaging in the evaluation in utero of Siamese twins]. 219 66

Acute autonomic and sensory neuropathy (AASN), one subtype of acute pandysautonomia, in which dorsal root ganglia and autonomic ganglia are involved is uncommon. Little is so far known on central nervous system involvement in AASN. In the present paper we described a rare case of AASN associated with the central nervous system manifestations such as galactorrhea-amenorrhea syndrome and intractable anorexia. A 30-year-old woman rapidly developed burning pain and numbness in her arms and legs as well as orthostatic syncope. She had severe anorexia and no no menstruation from onset. On physical examination, she was emaciated. There was marked orthostatic hypotension with tachycardia. Skin was dry. Moderate galactorrhea was detected. Neurological examination showed prominent paresthesia and dullness of superficial sensation, predominantly to pinprick and thermal stimuli, segmentally over the neck, occipital scalp, and extremities. Deep sensation was intact. She had no weakness or ataxia. Deep tendon reflexes were almost normal. NCV and SEP were normal, while EEG was abnormal. Sural nerve biopsy demonstrated axonal degeneration with the loss of myelinated, predominantly in small-caliber fibers, and unmyelinated fibers. The levels of HVA and MHPG in CSF were decreased. The autonomic nervous function tests revealed postganglionic dysfunction. alpha-adrenergic system was predominantly impaired, while beta-adrenergic system was relatively preserved. The endocrinological studies demonstrated mild or moderate elevation of PRL basal value and hyper-response of PRL and LH for TRH and LH-RH loading test, which suggested disorder of the hypothalamo-hypophysial system. Cranial MRI showed moderate dilatation of the 3rd ventricle.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Acute autonomic and sensory neuropathy associated with galactorrhea-amenorrhea syndrome and intractable anorexia]. 255 96

A 47-year-old woman complaining of cold intolerance, general weakness and amenorrhea of 10 months duration was diagnosed, by endocrine examinations, as having panhypopituitarism. Skull x-ray films revealed a slightly enlarged sella with double floor sign and MRI showed a low intensity mass in the pituitary. Transsphenoidal exploration disclosed a degenerated pituitary gland, the histology of which showed a granulomatous lesion with moderate lymphocytic infiltration but containing no multinuclear giant cells. No caseous necrosis, causative microorganisms, or BCG antigen were noted. The present case is considered a variant form of lymphocytic adenohypophysitis.
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PMID:A case of hypopituitarism due to granulomatous and lymphocytic adenohypophysitis with minimal pituitary enlargement: a possible variant of lymphocytic adenohypophysitis. 321 47

We report a case of Rathke's cleft cyst in pituitary tumor. A 31-year-old woman admitted to our hospital complained of visual disturbance, headache, amenorrhea and galactorrhea. Serum prolactin level was 3,060 ng/ml. By means of CT scan and MRI, we found suprasellar-extending tumor to have cystic component in the center of the tumor. Transsphenoidal surgery revealed grayish jelly-like content in the cyst. Histologically tumor cells were composed of chromophobic, basophilic and eosinophilic cells. The cyst wall in the pituitary adenoma was composed of ciliated or non-ciliated columnar epithelium intermingled with goblet cells, being similar to Rathke's cleft cyst. Except for the cells of the cyst wall, most of the tumor cells were immunoreactive for prolactin. As for intermediate filament, tumor cells in both solid and cystic portions showed positive immunoreactivity for cytokeratin and GFAP, and not for vimentin and neurofilament. These results suggest that the nature of the intracytoplasmic filament in the pituitary tumor with Rathke's cleft cyst may be not only keratin but also GFAP.
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PMID:[A case of prolactinoma in close association with Rathke's cleft cyst]. 332 Aug 6

Three cases of symptomatic Rathkes' cleft cyst are described. Case 1. A 51-year-old man was admitted to the hospital for evaluation of intermittent headache, in April, 1985. He was neurologically free, but skull films disclosed a ballooning of the sella with thinning of the dorsum sellae. CT scan showed enlargement of the sella, but no abnormal density area in the sellar region. MRI revealed a round mass with high signal intensity located just posteriorly to the pituitary body. By a transsphenoidal approach, a thin-walled cyst was found at the posterior portion of the sella. Turbid mucinous fluid and the capsule of the cyst were subtotally removed. Histologic section of the specimen demonstrated that its wall was composed of a loose fibrous tissue lined by a single layer of ciliated cuboidal epithelium containing some goblet cells. Electron microscopy showed ciliated cuboidal cells, cells with microvilli, cells with light and large granules, and basal cells abutting on the basal lamina. Case 2. A 33-year-old female was referred to the hospital with complaints of severe headache and decreased visual acuity 0.02 in the left and 0.1 in the right, in July, 1985. Visual field examination revealed bitemporal hemianopsia. She had amenorrhea, galactorrhea and polyuria. CT scan and metrizamide CT cisternography detected a low density mass in the suprasellar region. Endocrinological studies disclosed hyperprolactinemia with partial hypopituitarism. She had a right frontal craniotomy and a suprasellar cyst was subtotally removed. Histologically, a cystic wall was lined by pseudostratified columnar epithelium supported by a loose fibrous tissue.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Rathke's cleft cyst--report of three cases]. 361 39

A case of pituitary adenoma associated with Rathke's cleft cyst is reported. A 35-year-old woman suffering from visual disturbance, polydipsia-polyuria and amenorrhea galactorrhea was admitted. Since 3 years before admission, she had been administered thyradin under the diagnosis of primary hypothyroidism. Visual acuity was 0.1 on the right and 0.06 on the left, and visual field examination showed bitemporal hemianopsia. Endocrinological study disclosed primary hypothyroidism and moderate hypopituitarism. CT scan showed a low density mass with ring-like enhancement extending in the enlarged sellar cavity and in the suprasellar region. MRI showed a cystic mass in the sellar cavity extending to the suprasellar region, and a solid mass in the left posterior part of the sellar cavity, and the later was thought to be pituitary adenoma. On August 27, 1984, right frontal craniotomy was performed. The right optic nerve was compressed upward, and the right carotid artery laterally with a grayish bulging mass. About 3 ml of grayish colloidal fluid was aspirated and the capsule of the cyst was excised. Postoperative course was uneventful. The visual acuity and visual field defects were improved. Endocrine examination revealed panhypopituitarism. Histologically, the cyst wall was composed of ciliated columnar cells and partially stratified squamous cells. The solid part showed typical pituitary adenoma. There are 5 reports in the literature on the combination of a pituitary adenoma and a Rathke's cleft cyst. In our case, it is thought that the long-standing hypothyroidism induced pituitary adenoma. Therefore, our case with combination of a pituitary adenoma and a Rathke's cleft cyst should be regarded as an occasional coexistence rather than the entity of the transitional cell tumor.
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PMID:[A case of pituitary adenoma combined with Rathke's cleft cyst]. 370 47

Of the pituitary tumors, the prolactinoma is the most common, characteristically causing amenorrhea/galactorrhea in women and symptoms secondary to mass effect in men. Direct coronal CT scanning with rapid infusion contrast enhancement is now considered the most sensitive and specific method for evaluating the pituitary. Normally the gland is either homogeneous or heterogeneous in a repetitive fashion, and measures up to 9-10 mm in height. Adenomas typically are hypodense lesions in the anterior lobe associated with mass effect--superior surface convexity, gland enlargement, bony erosion, infundibulum displacement, or vascular "tuft" shift. High field superconductive MRI is thought to be superior to CT for evaluation of macroadenomas and may soon surpass CT in the evaluation of microadenomas. Treatment remains controversial. Perhaps surgery is the best alternative for women 15 to 30 years of age with microadenomas producing prolactin less than 100 ng/ml. Patients who are either beyond the child-bearing years, present with tumors greater than 10 mm in diameter, or have microadenomas producing prolactin greater than 100 ng/ml may be better served by medical therapy using bromocriptine or pergolide mesylate.
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PMID:Prolactinomas. Clinical presentation, radiologic assessment, and therapeutic options. 389 76

The therapeutic efficacy of sustained dopaminergic stimulation in Cushing's disease (CD), was investigated performing a three-month trial with monthly 50-100 mg injections of a bromocriptine depot preparation (Parlodel LAR, Sandoz) in six patients with CD. Dopaminergic treatment did not consistently influence pituitary-adrenal activity, as judged by plasma ACTH, cortisol and urinary free cortisol levels as well as by clinical findings. Interestingly, treatment with bromocriptine was associated with reappearance of menses in the three patients who were amenorrheic. In the five patients submitted to inferior petrosal sinus sampling, a parallelism between ACTH and PRL concentrations could be observed with a PRL rise, ipsilateral to that of ACTH, ensuing in three patients after administration of corticotropin-releasing hormone. In one patient a 55% reduction in the size of the pituitary adenoma was demonstrated by MRI carried out at the end of treatment. Our findings lead to the following conclusions: a) administration of depot injections of bromocriptine to patients with CD appears unable to correct hypercortisolism, although it can induce restoration of menses in amenorrheic patients; b) enhanced PRL concentrations at the pituitary level are probably involved in the amenorrhea often accompanying Cushing's disease.
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PMID:Effect of injectable bromocriptine in patients with Cushing's disease. 758 34


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