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A radiological and histological comparison of two unusual adrenal incidentalomas

Loong S, Selvarajan S, Khor LY

Malays J Pathol, 2019 Dec;41(3):327-331.
PMID: 31901917

INTRODUCTION: The increasing use of radiological imaging studies has given rise to 'incidentalomas'.
CASE REPORT: We describe two unusual and diverse incidental adrenal gland lesions, an adenomatoid nodule and a mature ganglioneuroma. Both are deemed 'indeterminate' on radiological assessment. On histology, an adenomatoid nodule is composed of variably-dilated thin-walled cysts lined by bland flattened cells and solid areas of tubules lined by eosinophilic cells with plump nuclei and prominent nucleoli. The lining cells are immunoreactive for calretinin and WT1 while negative for CK5/6, ERG and CD31. Mature ganglioneuroma features fascicles of bland spindle cells with intermixed mature ganglion cells disposed within a background myxoid stroma with no immature neuroblastic component. These spindled Schwann cells are S100 positive.
DISCUSSION: Both adenomatoid nodule and mature ganglioneuroma are rare benign adrenal tumours that need to be differentiated from other, more common adrenal lesions. The management of adrenal incidentalomas is challenging. Surgical excision is indicated if an adrenal incidentaloma is more than 4 cm in size, shows malignant features on imaging or evidence of hormone excess.
Synchronous papillary thyroid carcinoma and medullary thyroid carcinoma - a pitfall waiting to happen

Tang PY, Khor LY, Takano A

Malays J Pathol, 2017 Aug;39(2):171-174.
PMID: 28866700

Papillary thyroid carcinoma (PTC) is the most common thyroid carcinoma and is derived from thyroid follicular cells. In contrast, medullary thyroid carcinoma (MTC) is rare and originates from the parafollicular C-cells. Synchronous occurrence of these two carcinomas is uncommon and occurs as either discrete lesions or as a mixed lesion. The current case report describes a 50-year-old woman with synchronous multiple discrete MTC and PTC with lymph nodes metastasis. Pathologists and treating physicians should be aware of the synchronous coexistence of these entities to avoid possible misdiagnosis.
No association between peroxisome proliferator-activated receptor and uncoupling protein gene polymorphisms and obesity in Malaysian university students

Yiew SK, Khor LY, Tan ML, Pang CL, Chai VY, Kanachamy SS, et al.

Obes Res Clin Pract, 2010 Oct-Dec;4(4):e247-342.
PMID: 24345699 DOI: 10.1016/j.orcp.2010.03.002

Peroxisome proliferator-activated receptors (PPARs) and uncoupling proteins (UCPs) are expressed in adipose tissue, where PPARs are nuclear receptors that function as transcription regulators of the expression of UCPs, mitochondria proteins which uncouple protons in exchange of heat released. The PPARα L162V; PPARγ2 C161T; UCP1 -3826A/G; UCP2 45 bp Ins/Del and -866G/A; and UCP3 -55C/T gene polymorphisms have been previously associated with obesity in different populations, but with inconclusive findings. This study was to investigate the prevalence of these gene polymorphisms and their possible association with obesity in a cohort of Malaysian university students in Kuala Lumpur. Random convenience sampling was performed with informed consents and anthropometric measurements were taken. Mouthwash samples were obtained for genomic DNA extraction and genotyping was performed using Polymerase Chain Reaction - Restriction Fragment Length Polymorphism. Out of the 256 subjects (140 males and 116 females), 170 were lean and 86 were overweight/obese. The mutated PPARα L162V; PPARγ2 C161T; UCP1 -3826A/G; UCP2 45 bp Ins/Del and -866G/A; and UCP3 -55C/T allele frequencies were 0.006, 0.36, 0.58, 0.12, 0.56 and 0.34, respectively. This study failed to find significant differences in the anthropometric indicators of obesity (Body Mass Index, Waist-Hip Ratio and Total Body Fat) between the genotypes of all the PPAR and UCP gene variants. Overall, the genotype and allele distributions were also not significantly different between genders and BMI status. In conclusion, overweight/obesity is not prevalent among the Malaysian university students and the PPAR and UCP gene polymorphisms are not associated with obesity.:

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